Examination

Rapidly identifying injuries that may require urgent treatment and those that keep a player from returning to play are usually

Posterior talofibular

Fibulocalcaneal

Posterior talofibular a ft

Fibulocalcaneal

Figure 68-2 Lateral and medial ankle ligament anatomy. (From Pugh KJ: Fractures and soft-tissue injuries about the ankle. In Fitzgerald RH, Kaufer H, Malkami AL [eds]: Orthopaedics. St. Louis, Mosby, 2002, pp 420-421.)

malleolus may indicate injury to the deltoid ligament and may require stress radiographs to rule out an unstable fracture pattern more adequately treated with surgery. Weber C fractures are rarely stable and are almost always treated surgically. Bimalleolar ankle fractures are difficult to treat with closed means because of their instability. When closed management of bimalleolar ankle fractures is chosen, there must be anatomic alignment ensured with weekly serial radiographs for the first month, then biweekly until healed.

Nonoperative treatment usually consists of closed reduction and casting. With Weber A fractures, a removable boot can be applied, and weight bearing initiated as tolerated. For Weber B fractures treated nonoperatively, a short leg cast is applied and patients are non-weight bearing initially. The mechanism of injury as determined by the history and the Lauge-Hansen classification is reversed, the foot is placed in a plantigrade position, and the cast is molded to resist redisplacement. Maintenance of the normal mortise relationship must be ensured throughout

Interosseous membrane

Lateral

Anteroinferior tibiofibular ligament

Interosseous membrane

Lateral

Anteroinferior tibiofibular ligament

Anteroinferior tibiofibular ligament (cut)

Interosseous ligament

Anterior view

Figure 68-3 A and B, Syndesmosis anatomy. (From Coughlin MJ, Mann RA: Surgery of the Foot and Ankle, 7th ed. St. Louis, Mosby, 1999, p 1134.)

Anteroinferior tibiofibular ligament (cut)

Interosseous ligament

Interosseous membrane

Medial

Interosseous membrane

Medial

Posteroinferior tibiofibular ligament

Transverse tibiofibular ligament

Lateral

Posteroinferior tibiofibular ligament

Transverse tibiofibular ligament

Lateral

Anterior view

Posterior view

Figure 68-3 A and B, Syndesmosis anatomy. (From Coughlin MJ, Mann RA: Surgery of the Foot and Ankle, 7th ed. St. Louis, Mosby, 1999, p 1134.)

Lauge-Hansen Classification

Figure 68-4 Classification of ankle fractures. (From Pugh KJ: Fractures and soft-tissue injuries about the ankle. In Fitzgerald RH, Kaufer H, Malkami AL [eds]: Orthopaedics. St. Louis, Mosby, 2002, p 424.)

Danis-Weber Classification

Figure 68-4 Classification of ankle fractures. (From Pugh KJ: Fractures and soft-tissue injuries about the ankle. In Fitzgerald RH, Kaufer H, Malkami AL [eds]: Orthopaedics. St. Louis, Mosby, 2002, p 424.)

nonoperative treatment with serial radiographs. Bimalleolar ankle fractures require stabilization above the knee to manage rotatory deforming forces across the ankle (Fig. 68-6).

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Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

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