A 60-year-old man is transferred to your facility by ambulance following a motor vehicle crash that resulted in moderate damage to his vehicle. He was a restrained driver in a head-on collision. He was transferred because it was determined at the receiving hospital that he had a subdural hematoma.
Upon arrival, though, his biggest complaint is that his right ankle hurts. On examination, there is no obvious deformity; good pulses are present. There is mild to moderate soft tissue swelling; the patient has limited range of motion and complains of moderate tenderness on the dorsal and medial aspects of the ankle. Radiographs of the ankle are shown.
ANSWER
The radiographs demonstrate a large, mildly displaced fracture of the medial talus, as well as a small chip fracture off the distal tibia in the medial malleolus. The patient underwent open reduction and internal fixation, with good results.
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