- 3 Bones
- 3 Primary Joints
- Medial mal with medial talus
- Tibial plafond with talar dome
- Lateral mal with lat talus
- Medial clear space --- if over 4mm, its concerning for syndesmotic injury or possible deltoid ligament incompetence
- Tib-fib clear space --- greater than 5mm is abnormal
- Bi-mal and Tri-mal fxs often need surgery
- Pilon fractures ---- high injury mechanism!! - Be sure to get additional films to look at tibia, knee and also LUMBAR SPINE
- Pediatric patients are different
- Ligaments stronger
- More likely to fracture bone than sprain ligament
- Foot has 28 bones
- Divided into hindfoot, midfoot and forefoot
- Hindfoot controls inversion and eversion
- Midfoot controls foot abduction and adduction
- Forefoot controls plantarflexion and dorsiflexion
- Calcaneal fracture --- 10% associated lumbar fractures!!
- Talar neck fractures - very bad injury, minimal blood flow there; often times need OR for reduction
- LisFranc fracture dislocation - axial load and foot planted.
- Can be severe or subtle.
- If concerned for subtle, then get full weight bearing films.
- Jones fx - 5th metatarsal head fracture - Put in post-op shoe or splint, follow up; Majority non-op