Revise for Your FRCS Trauma & Orthopedic Exam with Our Comprehensive Guide

Get the best start possible with hundreds of EMI and SBA practice questions, mapped to the Royal College of Surgeons ISB Section 1 curriculum. Revise with quality questions and detailed explanations.

Demo Question: Ankle Fractures

With respect to ankle fractures, which of the following is correct?

1. 3 mm of talar shift leads to a decrease in tibiotalar contact by 50%
2. A medial clear space > 4 mm is indicative of a deltoid ligament injury
3. Concomitant osteochondral fractures of the talar dome are uncommon
4. Syndesmosis injuries can only occur with a Weber C type fracture of the lateral malleolus
5. The majority of fractures are due to a pronation external rotation injury

Key Learning Point

Normally the medial clear space (between talus and medial malleolus) should be less than 4 mm and when the medial space is > than 4 mm, then lateral shift of talus is present.

Explanation

The majority of fractures occur due to a supination- external rotation injury. Syndesmosis injuries can occur with low as well as high fibula fractures. Osteochondral defects can occur in up to 40% of ankle fractures in some series. Normally the medial clear space (between talus and medial malleolus) should be less than 4 mm and when the medial space is > than 4 mm, then lateral shift of talus is present. 1mm of talar shift decreases tibiotalar contact by 50%.