title: Initial management of ankle fractures in the overweight and obese: the providence pinch.
abstract: BACKGROUND
  Obese and overweight people have higher rates of ankle injury, particularly operative ankle fractures. The initial management of unstable ankle fractures includes closed reduction and splinting to limit soft tissue injury and articular cartilage damage until definitive operative fixation can be performed. Adequate reduction can be more difficult in the obese patient due to the weight and additional padding provided by the larger soft tissue envelope.
  
  
  CONCLUSIONS
  A novel technique, described herein by the authors, may be useful in obtaining a suitable reduction of the ankle in the initial management of unstable ankle fractures in the overweight and obese.
  
  
  CONCLUSIONS
  Obese patients have unique musculoskeletal injury profiles and special considerations in their management. The authors have found this technique useful in the management of their ankle fractures.
authors.affiliation: Division of Trauma, Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: P Kaveh
authors.initials: PK
authors.lastname: Mansuripur
authors.affiliation: Division of Trauma, Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Deren
authors.affiliation: Division of Trauma, Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Roman
authors.initials: R
authors.lastname: Hayda
authors.affiliation: Division of Trauma, Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Born
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D064386:Ankle Fractures / Q000150:complications / Q000628:therapy*; D002370:Casts, Surgical; D006801:Humans; D008349:Manipulation, Orthopedic / Q000379:methods*; D009765:Obesity / Q000150:complications*; D013165:Splints; D016683:Supine Position
chemical_list: D000700:Analgesics
keywords: ankle; dislocation; fracture; obese; overweight; reduction