title: Fractures of the ankle joint: investigation and treatment options.
abstract: BACKGROUND
  Ankle fractures are common, with an incidence of up to 174 cases per 100 000 adults per year. Their correct classification and treatment are of decisive importance for clinical outcome.
  
  
  METHODS
  Selective review of the literature.
  
  
  RESULTS
  Ankle fractures are initially evaluated by physical examination and then by x-ray. They can be classified according to either the AO Foundation (Association for the Study of Internal Fixation) or the Weber classification. Dislocated fractures need emergency treatment with immediate reduction; this is crucial for the prevention of hypoperfusion and nerve damage. Weber A fractures can usually be treated conservatively, while Weber B and C fractures are usually treated with surgery. An evaluation of the stability of the syndesmosis is important for anatomical reconstruction of the joint. Wound hematoma and wound-edge necrosis are the most common complications, and the postoperative infection rate is 2%. Up to 10% of patients develop ankle arthrosis over the intermediate or long term.
  
  
  CONCLUSIONS
  With properly chosen treatment, a good clinical outcome can be achieved. The long-term objective is to prevent post-traumatic ankle arthrosis. The evidence level for optimal treatment strategies is low.
authors.affiliation: Department of Orthopedic and Trauma Surgery, University Hospital Bonn, Orthopedic Department at the University Hospital of Basel, Switzerland, HG and MDW have equally contributed to the manuscript.
authors.forename: Hans
authors.initials: H
authors.lastname: Goost
authors.forename: Matthias D
authors.initials: MD
authors.lastname: Wimmer
authors.forename: Alexej
authors.initials: A
authors.lastname: Barg
authors.forename: Kouroush
authors.initials: K
authors.lastname: Kabir
authors.forename: Victor
authors.initials: V
authors.lastname: Valderrabano
authors.forename: Christof
authors.initials: C
authors.lastname: Burger
mesh_terms: D064386:Ankle Fractures / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000379:methods*; D061826:Foot Orthoses; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010808:Physical Examination / Q000379:methods*; D026741:Physical Therapy Modalities; D012720:Severity of Illness Index