Evidence brief
Surgical vs Conservative Treatment of Ankle Fractures
Anatomic reduction critical for outcomes
Displaced fractures require surgical reduction
Syndesmotic stability assessment essential
Stable fractures can be treated non-operatively
Long-term arthritis related to articular incongruity
Ankle fracture management depends on stability and articular congruity. Displaced and unstable patterns require surgical fixation to restore anatomy and prevent arthritis.
Know Weber/Danis-Weber classification (A, B, C based on fibula level). Lauge-Hansen for mechanism. Key: syndesmotic stability. Stress views, MRI if uncertain. Indications for surgery: >2mm talar shift, syndesmotic injury, unstable pattern. Discuss fixation principles.
Bauer M et al. Malleolar fractures: nonoperative versus operative treatment. A controlled study. Clin Orthop Relat Res. 1985;(199):17-27.
Level I
Systematic review of RCTs or high-quality RCT