Displaced, unstable ankle fractures: classification, incidence, and management of a consecutive series.

A review of 157 displaced, unstable ankle fractures has suggested that external rotation injuries cause most ankle fractures, with pronation type injuries being six times more common than supination type injuries. Accurate, rigid fixation of displaced unstable ankle fractures tends to prevent talar tilt and lessens the tendency for arthrosis. If the fibula is not fixed, it tends to shorten and allows talar tilt or spread of the syndesmosis with resulting arthrosis. Minimal external fixation is desirable, and rapid restoration of motion is needed.