title: Bivalved fiberglass cast compared with plaster splint immobilization for initial management of ankle fracture-dislocations: a treatment algorithm.
abstract: The initial management of ankle fracture-dislocations is the crucial step in the treatment of these emergent traumatic injuries. A stepwise approach is necessary to properly evaluate, diagnose, and treat ankle fracture-dislocations. The goal of initial management is to evaluate the vascular status of the extremity and then restore proper alignment of the talus underneath the tibia. A retrospective review was performed on 40 patients, who presented to a community-based hospital emergency room, treated by the foot and ankle service for ankle fracture-dislocation. An analysis of patient demographics, injury pattern/classification, number of reduction attempts, and immobilization method was performed and evaluated. This analysis was correlated with a review of the literature to develop an algorithm for the initial management of ankle fracture-dislocations recommending the use of a bivalved below-the-knee fiberglass cast for maintained stabilization post reduction.
  
  
  METHODS
  Therapeutic Level IV.
authors.affiliation: Weil Foot & Ankle Institute, Des Plaines, Illinois 60016, USA. jrb@weil4feet.com
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Baker
authors.forename: Shail N
authors.initials: SN
authors.lastname: Patel
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Teichman
authors.forename: Summer E S
authors.initials: SE
authors.lastname: Bochat
authors.forename: Adam E
authors.initials: AE
authors.lastname: Fleischer
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Knight
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016512:Ankle Injuries / Q000628:therapy*; D002370:Casts, Surgical; D002648:Child; D005260:Female; D050723:Fractures, Bone / Q000628:therapy*; D005596:Fractures, Closed / Q000628:therapy; D006801:Humans; D007103:Immobilization / Q000295:instrumentation; D004204:Joint Dislocations / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013165:Splints; D055815:Young Adult