External Rotation Injuries

  • William C. Hamilton

Abstract

Although supination-adduction is the most common mechanism producing ankle injury, external rotation of the foot with respect to the lower leg is the most common mechanism resulting in ankle fracture [46,47,54]. Lauge-Hansen described two varieties of external rotation fracture, depending on whether the foot was supinated or pronated at the moment of injury (Fig. 10.1). Supination-external rotation injuries will be discussed in this chapter, and pronation-external rotation injuries will be discussed in Chapter 11.

Fig. 10.1

External rotation injuries. A Supination-external rotation. B Pronation-external rotation.

Keywords

Immobilization Tate Paral Dial Mast 

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References

  1. 1.
    Ashhurst APC, Bromer RS: Classification and mechanism of fractures of the leg bones involving the ankle. AMA Arch Surg 4: 51, 1922.Google Scholar
  2. 2.
    Bergkvist A, Hultengren N, Lindholm A, Lindvall N: Circumferential wire fixation of the lateral malleolus for fractures at the ankle. Acta Chir Scand 115: 476, 1958.PubMedGoogle Scholar
  3. 3.
    Berridge FR, Bonnin JG: The radiographic examination of the ankle joint including arthrography. Surg Gynecol Obstet 79: 383, 1944.Google Scholar
  4. 4.
    Bistrom O: Conservative treatment of severe ankle fractures. A clinical and follow-up study. Acta Chir Scand (Suppl) 168:1, 1952.Google Scholar
  5. 5.
    Bohler L: The Treatment of Fractures, 5th ed. New York, Grone & Stratton, 1956.Google Scholar
  6. 6.
    Bonnin JG: Injuries to the Ankle. New York, Grone & Stratton, 1950.Google Scholar
  7. 7.
    Bonnin JG: Injury to the ligaments of the ankle. J Bone Joint Surg 47B: 609, 1965.Google Scholar
  8. 8.
    Bosworth DM: Fracture-dislocation of the ankle with fixed displacement of the fibula behind the tibia. J Bone Joint Surg 29: 130, 1947.PubMedGoogle Scholar
  9. 9.
    Braunstein PW, Wade PA: Treatment of unstable fractures of the ankle. Ann Surg 149: 217, 1959.PubMedCrossRefGoogle Scholar
  10. 10.
    Brodie IAOD, Denham RA: The treatment of unstable ankle fractures. J Bone Joint Surg 56B: 256, 1974.Google Scholar
  11. 11.
    Broomhead R: Discussion on fractures in the region of ankle joint. Proc Roy Soc Med 25:1082, 1932.Google Scholar
  12. 12.
    Brostrom L: Sprained ankles. I. Anatomic lesions in recent sprains. Acta Chir Scand 128:483, 1964.Google Scholar
  13. 13.
    Burgess E: Fractures of the ankle. J Bone Joint Surg 26:721, 1944.Google Scholar
  14. 14.
    Bums BH: Diastasis of the inferior tibio-fibular joint. Proc Roy Soc Med 36:330, 1943.Google Scholar
  15. 15.
    Burwell HN, Charnley AD: Treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement. J Bone Joint Surg 47B:634, 1965.Google Scholar
  16. 16.
    Cave EF (ed): Ankle injuries. In: Fractures and Other Injuries. Chicago, Year Book Medical, 1958.Google Scholar
  17. 17.
    Cedell C-A, Wiberg G: Treatment of eversion supination fracture of the ankle (second degree).Acta Chir Scand 124:41, 1962.Google Scholar
  18. 18.
    Cedell C-A: Supination-outward rotation injuries of the ankle. Acta Orthop Scand (Suppl) 110:1, 1967.Google Scholar
  19. 19.
    Charnley J: The Closed Treatment of Common Fractures, 3rd ed. Baltimore, Williams & Wilkins, 1972.Google Scholar
  20. 20.
    Childress HM: Vertical transarticular pin fixation for unstable ankle fractures. Impressions after 16 years of experience. Clin Orthop ReI Res 120:164, 1976.Google Scholar
  21. 21.
    Close R: Some applications of the functional anatomy of the ankle joint. J Bone Joint Surg 38A: 761, 1956.PubMedGoogle Scholar
  22. 22.
    Colton CL: Fracture-diastasis of the inferior tibio-fibular joint. J Bone Joint Surg 50B: 830, 1968.Google Scholar
  23. 23.
    Cox FJ, Laxson WW: Fractures about the ankle joint. Am J Surg 83: 674, 1952.PubMedCrossRefGoogle Scholar
  24. 24.
    Denham RA: Internal fixation for unstable ankle fractures. J Bone Joint Surg 46B: 206, 1964.Google Scholar
  25. 25.
    De Palma AF: The Management of Fractures and Dislocations, 2nd ed. Philadelphia, Saunders, 1970.Google Scholar
  26. 26.
    De Souza Dias L, Foerster TP: Traumatic lesions of the ankle joint. The supination-external rotation mechanism. Clin Orthop ReI Res 100: 219, 1974.Google Scholar
  27. 27.
    Eventov I, Salama R, Goodwin DRA, Weissman SL: An evaluation of surgical and conservative treatment of fractures of the ankle in 200 Patients. J Trauma 18: 271, 1978.PubMedCrossRefGoogle Scholar
  28. 28.
    Fairbank HAT: The operative treatment of ankle fractures. III. Lancet 2: 92, 1926.CrossRefGoogle Scholar
  29. 29.
    Gaston SR, McLaughlin HL: Complex fracture of the lateral malleolus. J Trauma 1: 69, 1961.CrossRefGoogle Scholar
  30. 30.
    Grath G: Widening of the ankle mortise. A clinical and experimental study. Acta Chir Scand (Suppl) 263: 1, 1960.Google Scholar
  31. 31.
    Gristina AG, Rovere GD, Moses TE, Nicasto JF, Poehling GG: Injuries of the ankle syndesmosis: Base slider's ankle fracture. Orthop Rev 8: 75, 1979.Google Scholar
  32. 32.
    Hall H: A simplified workable classification of ankle fractures. In Bateman JE, Trott AW (eds): The Foot and Ankle. New York, Thieme-Stratton, 1980.Google Scholar
  33. 33.
    Harvey JP Jr: Fractures of the ankle. A clinical survey of 181 cases. Clin Orthop 42: 57, 1965.PubMedGoogle Scholar
  34. 34.
    Henderson MS, Stuck WG: Fractures of the ankle: Recent and old. J Bone Joint Surg 15: 882, 1933.Google Scholar
  35. 35.
    Hughes J: The medial malleolus in ankle fractures. Orthop Clin of North Am 11: 649, 1980.Google Scholar
  36. 36.
    Jergesen F; Open reduction of fractures and dislocations of the ankle. Am J Surg 98: 136, 1959.PubMedCrossRefGoogle Scholar
  37. 37.
    Joy G, Patzakis MJ, Harvey JP Jr: Precise evaluation of the reduction of severe ankle fractures. Technique and correlation with end results. J Bone Joint Surg 56A: 979, 1974.PubMedGoogle Scholar
  38. 38.
    Key JA, Conwell HE: Injuries in the region of the ankle. In: The Management of Fractures, Dislocations and Sprains, 6th ed. St. Louis, Mosby, 1956.Google Scholar
  39. 39.
    Kleiger B: Treatment of oblique fractures of the fibula. J Bone Joint Surg 43: 969, 1961.Google Scholar
  40. 40.
    Kleiger B: Mechanisms of ankle injury. Orthop Clin North Am 5: 127, 1974.PubMedGoogle Scholar
  41. 41.
    Klossner O: Late results of operative and non operative treatment of severe ankle fractures. A clinicalstudy. Acta Chir Scand(Suppl)293: 1, 1962.Google Scholar
  42. 42.
    Kuntscher G: Practice of Intramedullary Nailing. Translated by H.H. Rinne. Springfield, Ill., Thomas, 1967.Google Scholar
  43. 43.
    Laros GS, Spiegel PG: Rigid internal fixation of fractures. Clin Orthop ReI Res 138: 2, 1979.Google Scholar
  44. 44.
    Lauge-Hansen N: Fractures of the ankle. II. Combined experimental-surgical and experimental-roentgenologic investigations. Arch Surg 60: 957, 1950.PubMedGoogle Scholar
  45. 45.
    Lauge-Hansen N: Fractures of the ankle. III. Genetic roentgenologic diagnosis of fractures of the ankle. Am J Roentgenol 71: 456, 1954.Google Scholar
  46. 46.
    Lauge-Hansen N: Fractures of the ankle. IV. Clinical use of the genetic roentgen diagnosis and genetic reduction. AMA Arch Surg 64: 488, 1952.PubMedGoogle Scholar
  47. 47.
    Lindsjo U: Operative treatment of ankle fractures. Acta Orthop Scand (Suppl) 189: 1, 1981.Google Scholar
  48. 48.
    Magnusson R: On the late results in non-operated cases of malleolar fractures. I. Fractures by external rotation. Acta Chir Scand (Suppl) 84: 1, 1944.Google Scholar
  49. 49.
    Malka JS, Taillard W: Results of non-operative and operative treatment of fractures of the ankle. Clin Orthop ReI Res 67: 159, 1969.Google Scholar
  50. 50.
    Mast JW, Teipner WA: A reproducible approach to the internal fixation of adult ankle fractures: Rationale, technique and early results. Orthop Clin North Am 11: 661, 1980.PubMedGoogle Scholar
  51. 51.
    McLaughlin HL, Ryder CT Jr: Open reduction and internal fixation for fractures of the tibia and ankle. Surg Clin North Am 29: 1523, 1949.PubMedGoogle Scholar
  52. 52.
    McLaughlin HL: Trauma. Philadelphia, Saunders, 1960.Google Scholar
  53. 53.
    Menelaus MB: Injuries of the anterior inferior tibio-fibular ligament. Aust NZ J Surg 30: 279, 1960.CrossRefGoogle Scholar
  54. 54.
    Meyer TL Jr, Kumler KW: A.S.I.F. technique and ankle fractures. Clin Orthop ReI Res 150: 211, 1980.Google Scholar
  55. 55.
    Mitchell CL, Fleming JL: Fractures and fracturedislocations of the ankle. Postgrad Med 26: 773, 1959.PubMedGoogle Scholar
  56. 56.
    Mitchell WG, Shaftan GW, Sclafani S: Mandatory open reduction: Its role in displaced ankle fractures. J Trauma 19: 602, 1979.PubMedCrossRefGoogle Scholar
  57. 57.
    Monk CJE: Injuries of the tibiofibular ligaments. J Bone Joint Surg 51: 330, 1969.Google Scholar
  58. 58.
    MUllerME, Allgower M, Schneider R, Willenegger H: Manual of Internal Fixation, 2nd ed. Translated by J. Schatzker. New York, SpringerVerlag, 1979.Google Scholar
  59. 59.
    Nahigian SH, Oh I, Zahrawi FB: Wire-loop fixation of the lateral malleolus in ankle fractures. In Bateman JE, Trott AW (eds): The Foot and Ankle. New York, Thieme-Stratton, 1980.Google Scholar
  60. 60.
    Neer CS II: Injuries of the ankle joint-evaluation. Connecticut State Med J 17: 580, 1953.Google Scholar
  61. 61.
    Neufeld AJ: Ankle joint fractures and their treatment. Clin Orthop 42: 91, 1965.PubMedGoogle Scholar
  62. 62.
    Nystrom G: A contribution to the treatment of fractures of the posterior border of the tibia by malleolar fractures. Acta Radiol 25: 672, 1944.CrossRefGoogle Scholar
  63. 63.
    O I, Nahigian SH, Salas AS, Zahrawi FB: Cerclage of the lateral malleolus in displaced fracture of the ankle. Orthopaedics 1: 374, 1978.Google Scholar
  64. 64.
    Pankovich AM: Maisonneuve fracture of the fibula. J Bone Joint Surg 58A: 337, 1976.PubMedGoogle Scholar
  65. 65.
    Pankovich AM: Fractures of the fibula proximal to the distal tibiofibular syndesmosis. J Bone Joint Surg 6OA: 221, 1978.Google Scholar
  66. 66.
    Pankovich AM: Fractures of the fibula at the distal tibiofibular syndesmosis. Clin Orthop ReI Res 143: 138, 1979.Google Scholar
  67. 67.
    Pankovich AM: Adult ankle fractures. JCE Orthop 7: 17, 1979.CrossRefGoogle Scholar
  68. 68.
    Pankovich AM, Shivaram MS: Anatomical basis of variability in injuries of medial malleolus and the deltoid ligament. I. Anatomical studies. Acta Orthop Scand 50: 217, 1979.PubMedCrossRefGoogle Scholar
  69. 69.
    Pankovich AM, Shivaram MS: Anatomical basis of variability in injuries of medial malleolus and deltoid ligament. II. Clinical studies. Acta Orthop Scand 50: 225, 1979.PubMedCrossRefGoogle Scholar
  70. 70.
    Patrick J: A direct approach to trimalleolar fractures. J Bone Joint Surg 47B: 236, 1965.Google Scholar
  71. 71.
    Proctor H: Lateral rotation fracture-dislocation of ankle. J Bone Joint Surg 36B: 148, 1954.Google Scholar
  72. 72.
    Purvis GD: The unstable oblique distal fibular fracture. Clin Orthop ReI Res 92: 330, 1973.CrossRefGoogle Scholar
  73. 73.
    Quigley TB: Management of ankle injuries sustained in sports. JAMA 169: 1431, 1959.Google Scholar
  74. 74.
    Quigley TB: Analysis and treatment of ankle injuries produced by rotatory, abduction and adduction forces. Instructional Course Lectures. Am Acad Orthop Surg 19: 172, 1970.Google Scholar
  75. 75.
    Rush LV: Atlas of Rush Pin Technics. A System of Fracture Treatment. Meridian, Miss. Berivon, 1955.Google Scholar
  76. 76.
    Rütt A: Surgery of the Lower Leg and Foot. Translated by G. Stiasny. Philadelphia, Saunders, 1980Google Scholar
  77. 77.
    Sarkisian JS, Cody GW: Closed treatment of ankle fractures. A new criterion for evaluation. A review of 250 cases. J Trauma 16: 323, 1976.PubMedCrossRefGoogle Scholar
  78. 78.
    Solonen KA, Lauttamus L: Treatment of malleolar fractures. Acta Orthop Scand 36: 321, 1965PubMedGoogle Scholar
  79. 79.
    Solonen KA, Lauttamus L: Operative treatment of ankle fractures. Acta Orthop Scand 39: 223, 1968.PubMedCrossRefGoogle Scholar
  80. 80.
    Staples OS: Injuries to the medial ligaments of the ankle. J Bone Joint Surg 42A: 1287, 1960Google Scholar
  81. 81.
    Sudman E: Compression osteosynthesis of lateral malleolar fractures with the figure-of-eight cerclage. Acta Chir Scand 140: 37, 1974.Google Scholar
  82. 82.
    Sudman E: Compression osteosynthesis of lateral malleolar fractures with the figure-of-eight cerclage. Acta Chir Scand 140: 37, 1974.Google Scholar
  83. 83.
    Svend-Hansen H, Bremerskov U, Baekgaard N: Ankle fractures treated by fixation of medial malleolus alone. Late results in 29 patients. Acta Orthop Scand 49: 211, 1978.PubMedCrossRefGoogle Scholar
  84. 84.
    Vasli S: Operative treatment of ankle fractures. Acta Chir Scand (Suppl) 226: 1, 1957.Google Scholar
  85. 85.
    Wade PA, Lance EM: The operative treatment of fracture-dislocation of the ankle joint. Clin Orthop Rei Res 42: 37, 1965.Google Scholar
  86. 86.
    Walsh WM, Hughston JC: Unstable ankle fractures in athletes. Am J Sports Med 4: 173, 1976.PubMedCrossRefGoogle Scholar
  87. 87.
    Watson-Jones R: Fractures and Other Joint Injuries, 4th ed. Baltimore, Williams & Wilkins, 1955.Google Scholar
  88. 88.
    Yablon IG, Heller FG, Shouse L: The key role of the lateral malleolus in displaced fractures of the ankle. J Bone Joint Surg 59A: 169, 1977.PubMedGoogle Scholar
  89. 89.
    Yablon IG, Wasilewski S: Management ofunstable ankle fracture. In Bateman JE, Trott AW (eds): The Foot and Ankle. New York, Thieme- Stratton, 1980Google Scholar
  90. 90.
    Yablon IG, Wasilewski S: Isolated fractures of the lateral malleolus. Orthopedics 4: 301, 1981.Google Scholar
  91. 91.
    Yde J: The Lauge-Hansen classification of malleolar fractures. Acta Orthop Scand 51: 181, 1980.PubMedCrossRefGoogle Scholar
  92. 92.
    Yde J, Kristensen KD: Ankle fractures: Supination-eversion fractures, stage II. Acta Orthop Scand 51: 695, 1980PubMedCrossRefGoogle Scholar
  93. 93.
    Yde J, Kristensen KD: Ankle fractures: Supination-eversion fractures, stage IV. Acta Orthop Scand 51: 981, 1980.PubMedCrossRefGoogle Scholar
  94. 94.
    Zuelzer WA: Fixation of small but important bone fragments with a hook plate. J Bone Joint Surg 33A: 430 1951.PubMedGoogle Scholar

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© Springer-Verlag New York Inc. 1984

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  • William C. Hamilton

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