CME On Demand 2025: Management of the Complicated Ankle Fracture-AOFAS/FLAMeCiPP Joint Webinar: Management of the Complicated Ankle Fracture

Video Transcription

Video Summary

The AOFAS and FLAMS CIPP hosted a joint webinar on managing complex ankle fractures, moderated by Dr. Amanda Fantry with Drs. Pablo Segura and Andrew Thome. Dr. Fantry emphasized the importance of anatomic fixation of posterior malleolar fractures, advocating for tailored surgical approaches (posteromedial or posterolateral) depending on fracture classification and cautioned against dual posterior approaches due to risk of stiffness from scarring. She recommended CT scans for precise fracture assessment, especially in trimalleolar injuries.<br /><br />Dr. Segura discussed syndesmotic injuries linked with ankle fractures, highlighting that the syndesmosis is a dynamic joint stabilized by key ligaments, and that instability often involves injury to multiple ligaments. He reviewed diagnostic challenges, the use of stress tests intraoperatively, and fixation options including screw versus flexible fixation, noting that flexible fixation is increasingly favored for physiological stability.<br /><br />Dr. Thome focused on limb salvage and post-traumatic defects when the joint is unsalvageable. He emphasized multidisciplinary care, staging surgeries to gather clinical information, and using structural allografts or autografts for large defects. He highlighted options like total talus arthroplasty for select patients, underlining careful patient selection and preoperative planning including prosthetic consultations.<br /><br />Overall, the webinar underscored individualized surgical planning, the value of CT imaging, proper fixation strategies, and multidisciplinary approaches in managing complex ankle fractures and complications.

Asset Subtitle

Moderator: Amanda J. Fantry, MD
Faculty: Florencio Pablo Segura, MD; Andrew P. Thome Jr., MD

In this webinar, faculty from the AOFAS and Federación Latinoamericana de Medicina y Cirugía de la Pierna y el Pie (FLAMeCiPP) will present management approaches for complex ankle fractures, including posterior malleolar fractures and syndesmotic injuries, as well as discuss salvage options in the setting of bone loss, deformity, and failure.

At the conclusion of this webinar, you will be able to:

Understand key principles in managing posterior malleolar injuries and explore surgical techniques for treating trimalleolar ankle fractures
Review the important role of the syndesmosis in ankle fractures and how to avoid pitfalls during reduction and fixation
Discuss approaches and salvage techniques for managing complex ankle fracture cases with bone loss, deformity, and failure

Keywords

AOFAS

FLAMS CIPP

complex ankle fractures

posterior malleolar fractures

syndesmotic injuries

anatomic fixation

CT scans

limb salvage

total talus arthroplasty