Emergency Department Management of Ankle Fractures: A Narrative Review

Ankle fractures are among the most common orthopedic injuries encountered in the emergency department. Nearly half occur secondary to low-energy mechanisms such as ground-level falls, and approximately one-fourth ultimately require surgery. Appropriate acute management and disposition by providers in the acute setting is crucial to optimizing patient outcomes. This begins with a general knowledge of the commonly used Danis-Weber and Lauge-Hansen classification system, which helps categorize the majority of ankle fracture patterns encountered. Initial management includes timely reduction, multimodal pain control, and appropriate immobilization. Available resources, provider experience, and interfacility practice patterns influence specific management decisions; however, multiple effective treatment strategies exist. This review provides a concise resource regarding emergency department management and the different reduction maneuvers that can be utilized.