1 July 2022 at 18:04:18
X-Ray full length tibia/fibula to rule out proximal fibula fracture.
On-line referral to VFC if undisplaced and no fibular fracture. Refer to Ortho on-call if displaced or associated fibular fracture
Info
If a medial malleolus fracture is identified, it is important to rule out a Maisonneuve fracture as this indicates an unstable injury. A Maisonneuve fracture involves a medial malleolus fracture associated with a proximal fibular fracture. (This can be missed on an ankle x ray). Clinical tenderness at the proximal fibular or pain on "Squeeze test" may point towards a Maisonneuve injury.
If a Maisonneuve injury is present, then
apply below knee backslab, non-weightbearing
provide VTE prophylaxis
refer to the ortho oncall team
Completely undisplaced medial malleolus fracture (without fibular fracture) can be managed non-operatively.
provide a walking boot
weight bear as tolerated
offer walking crutches if required
refer to VFC online
