Following stabilization of the lower leg, a supination/external rotation force is then applied to the ankle. A mechanical stress view is performed with the patient supine/sitting upright with the lower leg in 15-20° internal rotation.A “ stress” view of the ankle joint can assist in identifying injury to the deep deltoid ligament with associated ankle joint instability.Ankle radiographs can appear “normal” (may only have an occult deep deltoid ligament injury with minimal medial clear space widening and/or isolated posterior tubercle disruption).In addition to imaging of the ankle, tib-fib x-rays should also be obtained to evaluate the entire length of tibia/fibula. A pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint.There may have been a 'crack' sound when the leg was broken, and the shock and pain of breaking your. If its a severe fracture, the leg may be an odd shape and the bone may even be poking out of the skin. You usually will not be able to walk on it. Weakness of ankle dorsiflexion/subtalar joint (foot) eversion and/or numbness along the lateral lower leg/dorsum of the foot should raise clinical suspicion for a Maisonneuve injury. A broken leg (leg fracture) will be severely painful and may be swollen or bruised. The common peroneal nerve courses over fibular head, thus a meticulous neurologic exam is critical. ![]() Low-energy, nondisplaced (aligned) fractures, sometimes called toddler’s fractures, occur from minor falls and twisting injuries. Tibia and fibula fractures are characterized as either low-energy or high-energy. “SQUEEZE” test: compression of the tibia/fibula elicits pain in the ankle/lower leg. The fibula supports the tibia and helps stabilize the ankle and lower leg muscles.
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