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Ankle fractures are common as they are prostrate to torture and pressure due to body weight.(1 , 2)The specific part of the ankle joint that gets injured may dissent and can be a unmarried or a combine injury . Posterior malleolus is the fundament of the long bone of the peg , forge the ankle joint . Let us get laid about the cause , symptoms , diagnosis , discussion and retrieval time of ulterior malleolus crack .
Ankle is one of the crucial joint , which digest the weight of the soundbox . articulatio talocruralis fractures are a common event , which pass due to various drive , ranging from accidents to sport injuries.(3)Depending on the case of injury and the identification number of parts in which the bone violate during an ankle faulting , it is classified into important character .
Types of Ankle Fracture
The articulatio talocruralis joint is formed of two lower ramification clappers , tibia on the inner side and fibula on the knocked out side . Both the bones end with a bump on inner and kayoed side , which imprint a part of the articulatio talocruralis . The bump or protuberance on the inner side of ankle , which is the nethermost part of tibia is forebode median malleolus ; while the bump on the outer side is hollo the lateral malleolus . The low-pitched final stage of the shinbone also shape a humble component at the back , called the posterior malleolus , which too is a part of the ankle reefer .
ankle joint break can be medial malleolus fracture , sidelong malleolus fracture , bimalleolar ankle fracture ( both median and sidelong malleolus fracture ) , later malleolus fracture or trimalleolar fracture , where all the three piece , median , lateral and posterior malleolus are fractured.(4 , 5 )
Here , we look at ulterior malleolus fracture , its grounds , symptom , diagnosis , treatment and recovery clock time .
About Posterior Malleolus Fracture
ulterior malleolus fracture is not rough-cut , but it does occur in some cases.(6)It may be hard to handle posterior malleolus fracture , as the pattern of injury is often unpredictable and may be associated with other cracking as well . Also , considering the location and thin skin fold over it , a posterior malleolus fracture can easily damage the cutis and result in an open faulting .
A posterior malleolus fracture rarely come as a single fault and is mostly a part of trimalleolar fracture , in which other two malleolus are also wound and may also have other ligament and soft tissue injuries.(7)If there are multiple cracks or associated injury , a posterior malleolus fracture may be complicated to treat .
What Causes Posterior Malleolus Fracture?
It is often noted that isolate ulterior malleolus shift are rare and they are mostly seen with other ankle injuries . The causes of posterior malleolus fracture include : twisting the ankle reefer , falls , accidents or wound to the pegleg ; including sports injuries.(3)Sports that take sudden twist and turn , which can easily injure the mortise joint are one of the common causes of ankle shift , posterior malleolus fracture and trimalleolar fractures.(7)Rolling that leave from maverick or improper placing of the foot or landing on an uneven aerofoil , too can be one of the causal agency of later malleolus fracture.(7)Falls , tripping over too can make posterior malleolus fracture and trimalleolar fracture .
Some of the causes of posterior malleolus break also include a lineal blow to the ankle or sudden , forceful shock on the ankle , as during vehicular accident . Sometimes , repeated injury to the soft tissues , ligament tear or weakening of the supporting structures in aged the great unwashed or those with joint problems too can leave in trimalleolar ankle fractures and posterior malleolus fracture .
What are the Symptoms of Posterior Malleolus Fracture?
symptom of posterior malleolus fracture include pain at the posterior side of the ankle.(4)Pain may also be present on the privileged and extinct malleolus , if the ulterior malleolus break is link with fracture of other malleolus as well.(4)Pain is often bad on go the ankle joint , turn the ankle inwards or outwards with difficulty in standing or walk . Tenderness is observe in the spite region , which aggravates on practice imperativeness .
symptom of ulterior malleolus fracture stimulate due to weak ligaments may cause pain along with ligament unstableness . Another mutual symptom is the inability to endure weighting on the mortise joint , stand or walk . Pain may worsen and may be present even after low wallop activities like walk and eventually even at rest . Some may also know mortise joint stiffness and intumesce around the wound area . Other symptom of posterior malleolus fracture include : limited range of movements , infliction on propel or turning the ankle joint and difficulty in standing and walk .
What is the Diagnosis of Posterior Malleolus Fracture?
diagnosing of posterior malleolus fracture and associated injuries can be made based on the history , clinical examination andx - ray.(4)The history often reveals an fortuity , fall or sports injury , as the ill commence soon following the accidental injury . Examination of the mortise joint joint reveals pain , tenderness and extrusion , free-base on which a theory of multiple fractures and cushy tissue injury can be assess .
In worldwide , if there is pain sensation and tenderness at the median and lateral malleolus or if the person is unable to walk due to severe articulatio talocruralis pain and swelling , a fracture is suspected and x - ray is advisable .
The diagnosis of ulterior malleolus break can be confirmed by x - rays and other scanning probe .
cristal - irradiation confirm a break in the bone ; in this case , it could be ulterior and sometimes even median and lateral malleolus ( intimate and outer side of the ankle).(4)X - ray also gives an idea about the case and rigourousness of posterior malleolus break . If other indulgent tissue paper damage , ligament injury or other fractures are suspect , additional scans likeCT scanandMRImay be call for .
What is the Immediate Treatment of Posterior Malleolus Fracture?
The treatment of posterior malleolus faulting , in case of combat injury to the ankle joint , needs immediate discourse , which includes the pursuit .
pillow the joint and elevate the branch is often advisable for posterior malleolus fracture .
Icing can be done for pain and swelling resulting from posterior malleolus shift , but is well avoid if there is a severe injury or if a complicated fracture is associated with dislocation or displacement .
In case of deracination of bones , the intervention of later malleolus fracture would require joint step-down , in which the displaced bones are institute to their original position . This often needs emergency aesculapian assistance .
The possible action of nerve harm and other soft tissue injury must be evaluated to plan appropriate investigations and treatment .
discussion of posterior malleolus fracture , like any other eccentric of ankle fracture includes conservative ( non - surgical ) and operative coming . intervention selection depends on the type and severity of the fracture and the condition of the patient . In this , materialistic method acting of treatment are used , which include medicines , brace , rest andphysical therapy , admit clock time for the break to mend on its own .
Conservative Treatment of Posterior Malleolus Fracture
Usually , materialistic intervention of posterior malleolus fracture , is recommended for less stern and simple injury . Fractures that are often not out of position and in patient role who are not active , can be managed well with materialistic or non - operative discourse . materialistic treatment may also be advise when the fractured patch of os are too small to be repaired surgically . However , for treatment of ulterior malleolus break with dislocation or when more than 25 % of malleolus is involve , operative discussion is needed . The treatment of posterior malleolus break is crucial , as the gristle may be injured , which increases the peril of develop arthritis later .
button-down treatment of later malleolus fracture is exchangeable to other ankle fractures . It include the use of removable braces or short leg cast . The healing normally takes up to 6 week , during which , the fractured mortise joint is supported by the cast or braces . Depending on the term , the soul may be allow to bear weight or restrict from bearing weight on the hurt leg . Usually , weight bearing on the fractured peg is to be deflect for at least 6 week , military post which , it depends on the healing of the fracture .
Regular monitoring and repeated X - ray are taken to check the healing and to detect any change of military position of the posterior malleolus break .
Treatment of ulterior malleolus faulting also admit the use of non - steroidal anti - inflammatory drug ( NSAIDs ) for pain direction . Any additional medicines and accessory may also be considered , if appropriate . For citizenry with nutritionary deficiencies , diabetes , circulatory problems and elderly adults , appropriate medications require to be give to ensure right healing .
Surgical Treatment of Posterior Malleolus Fracture
Depending on the severeness and complications of the injury , the treatment of posterior malleolus crack may admit operative correction . Surgery is often execute to align and stabilize the bones , limit ligament price and speed up the recovery process . While the type of surgery depends on injury and bone fragments , most operative corrections are done using screw , plates and wiring option .
What are the Complications of Surgical Treatment for Posterior Malleolus Fracture
potential complication of surgery of later malleolus fracture include : the danger of infection and detain healing . Another important risk of later malleolus fracture is the cartilage damage , which increase the risk of mortise joint arthritis . People with diabetes , aged adults and those who fume may be at dandy risk of knottiness , as the wound healing may be slow in such cases . However , with appropriate seasonable intervention and effective direction , the complications can be minimize and right healing can be expected .
What are the Recovery Measures Needed for Healing of Posterior Malleolus Fracture?
Rehabilitation : Rehabilitation plays an important theatrical role in the treatment of ulterior malleolus crack . Whether the break is treat with buttoned-down or surgical discussion , appropriate rehabilitation programs promote honest healing and lose weight the risk of long term pain and knottiness . For surgical discussion of posterior malleolus fracture , former postoperative forcible therapy is often advised .
Physical Therapy : strong-arm therapy treatment of ulterior malleolus fracture take to better the movement of ankle roast and progress through exercising weight bearing and then standing andwalking . Exercises help to strengthen the support brawn , forbid injuries and further better healing .
Exercises : Weight training is increasingly done so that the healing of the ankle joint geological fault is assessed and it gains the military strength to bear free weight , so that partial and then complete weight aim can be done . This is done over a span of 3 to 4 months , post which most later malleolus fracture can get bring around .
How Much Is The Recovery Time for Posterior Malleolus Fracture?
Recovery time in posterior malleolus cracking varies from person to person and reckon on the type and severity of the trauma and the overall health of the person.(4)On an average the recovery time is approximately 6 weeks , while a lot depends on the rehabilitation.(4)If with posterior malleolus , all three malleolus are involve , like in trimalleolar fracture , the recovery meter may be more .
In cases that require surgery , convalescence time for posterior malleolus cracking is long , around 3 to 4 months . However , in some cases , the recovery time may be even longer while it may take time to return to sports . But with well-timed treatment and effective renewal , good healing and recuperation of posterior malleolus fracture can be expect .
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