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Medial malleolus fracture
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Medial malleolus fracture

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Contributors: Robert Lachky MD, Eric Ingerowski MD, FAAP
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Synopsis

Medial malleolus fractures are a type of ankle fracture typically caused by forced eversion and external rotation. Patients present with pain and swelling of the medial ankle after injury.

Patient recollection of the exact motion of the foot during the injury (supination, pronation, external rotation, internal rotation) often does not reliably correlate with the injury pattern seen on imaging or in the operating room. Therefore, the initial focus should be as follows:
  • Get a basic history (eg, whether injury occurred during a fall from a height, a sports activity, or a car accident).
  • Perform a thorough physical examination, including assessment for neurovascular deficit.
  • Reduce the fracture if necessary (particularly if there is a neurovascular deficit).
  • Evaluate x-rays for stability.
Risk factors for ankle fracture include obesity and smoking. Ankle fractures are not classic osteoporotic fractures (ie, bone density is not necessarily protective).

In most cases, patients will present immediately after an injury. Swelling can progress rapidly, and the degree of swelling has a major impact on the timing of surgery and can lead to complications.

Codes

ICD10CM:
S82.53XA – Displaced fracture of medial malleolus of unspecified tibia, initial encounter for closed fracture
S82.56XA – Nondisplaced fracture of medial malleolus of unspecified tibia, initial encounter for closed fracture

SNOMEDCT:
281531008 – Fracture of medial malleolus

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Last Reviewed: 06/20/2018
Last Updated: 06/29/2018
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Medial malleolus fracture
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Medial malleolus fracture : Ankle pain, Inability to bear weight, Joint deformity, Joint swelling, Ecchymosis, Ankle edema
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