title: [Problems and controversies in the treatment of ankle fractures].
abstract: Ankle fractures are the most frequent injuries of a load-bearing joint. Their treatment belongs to the daily routine in trauma surgery. However, despite an increased understanding of the mechanism of injury and relatively straightforward fixation techniques, the medium- to long-term results are often less than satisfactory. The following article therefore explicitly focusses on unsolved problems and controversies in the treatment of ankle fractures in the light of the current literature. These include the therapeutic and prognostic relevance of frequently used classification systems, criteria for the indication for surgery, frequent hazards in internal fixation, the question of whether and how to fix the posterior malleolus, and the detection and treatment of syndesmotic instability. Furthermore, trauma surgeons face the increasing incidence of ankle fractures in the elderly. The presence of osteoporosis, diabetes mellitus and neuropathic osteoarthropathy represents a special challenge.
authors.affiliation: Klinik und Poliklinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland. strammelt@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Rammelt
authors.forename: D
authors.initials: D
authors.lastname: Heim
authors.forename: L C
authors.initials: LC
authors.lastname: Hofbauer
authors.forename: R
authors.initials: R
authors.lastname: Grass
authors.forename: H
authors.initials: H
authors.lastname: Zwipp
mesh_terms: D016512:Ankle Injuries / Q000175:diagnosis / Q000601:surgery*; D001177:Arthropathy, Neurogenic / Q000175:diagnosis / Q000601:surgery; D003430:Cross-Sectional Studies; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D057072:Intra-Articular Fractures / Q000175:diagnosis / Q000601:surgery*; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery; D007593:Joint Instability / Q000209:etiology; D008279:Magnetic Resonance Imaging; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D012680:Sensitivity and Specificity; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery