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Updated: Aug 14, 2026

Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
Initial management of closed fracture-dislocations of the ankle
R Payne1, J C Kinmont, S M Moalypour
1Department of Accident and Emergency Medicine, Kingston General Hospital, Surrey, UK. becky_payne@hotmail.com
Background:
Immediate management of closed fracture-dislocations of the ankle requires urgent reduction and immobilisation of the ankle prior to definitive surgery.
Methods:
The management of 23 patients attending the accident and emergency department of a district general hospital with this type of injury were reviewed retrospectively.
Results:
Paramedic reduction was attempted in 1 of the 22 patients brought by ambulance. Triage categorisation was inappropriate in 14 patients. Unnecessary pre-reduction radiographs were obtained in 8 patients. Reduction was initially inadequate in 2 patients, and no post-reduction splintage was applied in a further 2 patients. Recording of skin and neurovascular status was inadequate in the majority of the patient's notes.
Conclusions:
The necessary urgent reduction and splintage is being delayed in some cases because of inadequate injury recognition, inappropriate triage categorisation and unnecessary radiographs.
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