These cases are are to get you to start thinking and questioning your beliefs ahead of the next webinar on ankle fractures and Lisfranc injuries.
We are joined for this webinar by:
- Lyndon Mason – Liverpool University Hospitals NHS Foundation Trust
- Jitendra Mangwani – University hospitals of Leicester
- Hiro Tanaka – Royal Gwent Hospital Newport
43 yrs male publican tripped over a step. Inversion injury to left ankle. Seen in ED and put in a backslab (injury view not available). The ED records report that he was diffusely swollen and painful medially.
No fractures are seen around the ankle on XR
The treating doctor decided to do a weight-bearing view in cast:
32 yrs male, sustained a twisting injury to his left ankle 2-days ago and sustained the injury above.
He was put in a backslab in ED and is now in fracture clinic.
A 24 yrs car salesman sustained this injury while playing football. The doctor in fracture clinic removed the backslab and took this weight-bearing X-ray (Image 1). The patient is happy to go with whatever treatment you recommend.
While you were pondering what to do, the helpful SHO goes and gets a CT of the ankle anyway (Image 2).
This case ends up on your trauma list for fixation. Regardless of your initial feelings on the case (discussed above), you’ve agreed to carry out ORIF (imagine one of the other consultants you owe a favour to has asked you specifically).
54 yrs female solicitor twisted her ankle getting out of the car. Plain X-rays and CT are shown.
Lyndon Mason explains how to use the CT scan to plan the surgical treatment of the posterior malleolus. Based on this you can select your surgical approach. Lyndon then talks us through how to perform the posterolateral, medial posteromedial, and posteromedial approach to the posterior malleolus.
29 yrs, fit and healthy store manager presents to fracture clinic having tripped whilst walking a week ago. He’s complaining about right midfoot pain.
She is able to weight bear in a boot but she finds it painful. Clinically she is painful and swollen over the midfoot. Some midfoot swelling but no plantar ecchymosis.
Please do post your thoughts about these cases in the comments section below.
For the answers to these questions and much more join our webinar this week, Wednesday at 8pm BST.