=====Ankle Injuries=====
====Ankle Fracture====
[{{ wiki:musculoskeletal:lowerlimb:weber_classification.jpg?300| **//Weber Classification of Lat malleolar fractures//**}}]
{{ :wiki:musculoskeletal:lowerlimb:ankle_xray_lines.png?200|}}
==Lateral Malleolar Fracture==
  *Weber classification according to proximity to syndesmosis
  *walking boot - for isolated lateral malleolus fracture with < 3mm displacement, intact mortise and no talar shift
  *if the mortise is well reduced, results from operative and non-operative treatment are similar
==Medial Malleolar fracture==
  *walking boot - nondisplaced fracture and tip avulsions
  *operative - any displacement or talar shift
==Bimalleolar fracture==
  *POP cast - elderly or can not tolerate anaesthetic
  *operative - others

==Post Malleolar fracture==
  *walking boot - <25% of articular surface involved (CT measurement as XRay unreliable), <2 mm articular stepoff, syndesmotic stability
  *operative - others

<wrap em>Treatment of ankle fractures is based on the stability of the ankle joint.</wrap>
  *Stable ankle fractures are those in which the talus remains centered under the tibia, meaning that no medial-sided injury (with resultant lateral shift of the talus) has occurred
  *stable fractures are usually managed non-operatively with protected weight bearing.

====Achilles tendonopathy====
  *tendinopathy is a degenerative not an inflammatory condition c/w tendinitis which is inflammatory
  *Haglund's syndrome - triad of 1. insertional achilles tendinopathy, 2. retrocalcaneal bursitis, 3. Haglund deformity (i.e. posterosuperior calcaneal exostosis)
  *tendinitis, tendinopathy and Achilles rupture have been associated with <wrap em>Fluoroquinolones</wrap> (ciprofloxacin, levofloxacin, pefloxacin, and norfloxacin)
  *has been seen within hours of 1st dose
  *Low-dose corticosteroids in isolation have been implicated in Achilles tendon rupture but used concomitantly with fluoroquinolones increases risk
  *fluoroquinolones should not be used in children because of the risk in load bearing cartilage

[[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080593/#:~:text=Relative%20Tenotoxicity%20of%20Fluoroquinolones&text=In%20another%20series%20(N%20%3D%2042,(31%25%20of%20patients)|J Athl 2014. Tendonopathies and fluoroquinolones in athletes]]\\ 
[[https://bjsm.bmj.com/content/36/4/239|achilles tendinopathy. J of sports med - a review 2002]]

==References include:==
https://www.orthobullets.com/trauma/1047/ankle-fractures\\ 
https://musculoskeletalkey.com/43-ankle-fractures-and-dislocations/\\