![]() bone screw(s) at the posterior malleolus (back part of the tibia) – if fracture and of sufficient size.bone screws at the inner knob of the ankle (medial malleolus) – if fractured. ![]() bone screws and a bone plate on the outside bone of the ankle (fibula).The name of the surgical procedure for repairing ankle fracture with an unstable syndesmosis is called an open reduction with internal fixation.ĭuring the procedure, your surgeon will restore the original alignment of the fractured bones and hold them in place with surgical hardware, typically: (See area 2 on the x-ray image) There may also be a fracture present at the inner knob of the ankle (the medial malleolus of the tibia), (see area 3 on the x-ray image), and/or the back of the tibia (the innermost / big leg bone) at the ankle joint (also called the posterior malleolus). (See area 1 on the x-ray image) Besides the fibular fracture and syndesmosis tear, one might also see that the talus (the bone in the ankle socket that moves up and down) is shifted towards the outside of the ankle. The fibular fracture may be found 1-2cm (0.5-1 inch) above the ankle joint level, or anywhere higher, including all of the way up to just below the knee. Typically, when the fibular (bone on the outside of the ankle) fracture occurs above the ankle joint level, there is an associated syndesmosis injury. Since ligaments (and the syndesmosis) cannot be directly visualized on radiographs (plain x-ray films), it is fortunate that we can reliably predict when there has been a syndesmosis injury in conjunction with the fracture(s). Thus, in an ankle fracture with an unstable syndesmosis, surgery is typically recommended. Because of a disrupted, unstable syndesmosis, the tibia and fibula are not held together properly, which makes for a very unstable ankle joint that is prone to chronic disability and arthritis – if not repaired. In some fractures, the ligament structures (called the syndesmosis) that hold together the two leg bones (the tibia and the fibula) that form the ankle socket are torn. Perhaps the most important “classification” of ankle fracture to both the doctor and the patient is whether the fracture will need surgical correction or not. Ankle fractures can be classified by the mechanism that caused that fracture, or the number of locations that have fractured, or by the location of the fracture of the fibula (the bone on the outside of the ankle) relative to the ankle joint line. There are many varieties of ankle fracture that can occur. Tips and Instructions from the Cast Room.Ankle Fracture with Unstable Syndesmosis.Patients with Sensation or Circulation Loss in the Feet.Midfoot Impingement Syndrome and Degenerative Joint Disease of the Midfoot.Excess Body Weight and Foot and Ankle Problems.561 Aftercare, musculoskeletal system and connective tissue without cc/mccĬonvert S82.560 Aftercare, musculoskeletal system and connective tissue with cc.559 Aftercare, musculoskeletal system and connective tissue with mcc.ICD-10-CM S82.401D is grouped within Diagnostic Related Group(s) (MS-DRG v41.0): S82.401D is considered exempt from POA reporting."Present On Admission" is defined as present at the time the order for inpatient admission occurs - conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA.
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