Operative approaches: Ankle

In an appropriately marked and consented anaesthetised patient.

I would complete the WHO checklist.

Patient would be supine on the table with sandbag under the ipsilateral limb.

Torniquet to 300mmHg

Incision 10cm in length over lateral malleolus.

Clean fracture edges

Reduce fracture with crocodile clamp

Lag screw + neutralisation plate

Closure in layers

I would complete the WHO checklist.

Patient would be supine on the table.

Torniquet to 300mmHg

Incision: 2cm distal to anterior tip of medial malleolus.

Identify the saphenous vein and nerve.

Hold fracture reduction with K wire.

2 x 4mm cancellous screw inserted perpendicular to fracture line.

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