Supination-Outward Rotation Injuries of the Ankle: A Clinical and Roentgenological Study with Special Reference to the Operative Treatment

Abstract

1. Earlier investigations 39 -2.Different types of rupture and their percentage distribution in the present study 40 VII.Occurrence of uninjured anterior tibiofibular ligament in combination with distal oblique fibular fracture 42 3 VIII.IX.x. XI. XII.XIII.PART II Distal oblique fibular fracture occurring in stage II, III and IV 43 A. Different types of fracture.Displacement of the distal fibular fragment 43 B. The proximal fibular fragment and its relation to the interosseous ligament and the tibia 44 Injuries of stage II 45 A. Clinical diagnosis 45 B. Roentgenological diagnosis 45 C. Operative examination 46 Injuries of stage III 49 A. Clinical diagnosis 49 B. Roentgenological diagnosis 50 C.The posterior tibial fragment and its variations in shape and size 50 Injuries of stage IV 52 A. Fracture of the medial malleolus 52 1. Clinical diagnosis 52 -2.Roentgenological diagnosis 52 -3.Operative examination 54 B. Rupture of the deltoid ligament 54 1. Clinical diagnosis 54 -2.Roentgenological diagnosis 54 -3.Operative examination 55 C. Correlation between the frequency of fracture of the medial malleolus and rupture of the deltoid ligament 57 D. Frequency, size and displacement of the posterior tibial fragments 57 E. Luxation injuries 58 1. Correlation to sex and age 58 -2.Clinical diagnosis 59 -3.Roentgenological diagnosis 60 -4.Correlation to the size of the posterior tibial fragments 60 Injuries of the talus 60 Summary 62 Method of operative reconstruction.Primary clinical and roentgenological results of treatment 65 4 XIV.XV.XVI.Earlier methods of treatment 67 Operative method in the present study 71 A. General principles 71 B. Preoperative treatment and time of operation 72 C. Operative anesthesia, approach and technique 73 D. The metal staple and other fixation devices used 74 Operative treatment of the different stages of supination-outward rotation injuries 77 XVII.XVIII.