Rockwood Adults CH64

2836

SECTION FOUR • Lower Extremity

A

B

Figure 64-9.  AP and lateral radiographs of a supination external rotation (SER 2) fracture (AO/OTA B1.1). Note the oblique fracture line with the long posterior spike. The talus is congruent.

A, B

C

Figure 64-10.  A supination-adduction (SAD2) fracture (AO/OTA A2.2). A: The initial AP radiograph shows impaction of the medial plafond and an avulsion fracture of the fibula. B: An intraoperative radio- graph. The impacted region must be reduced. This is achieved through the fracture using a punch or lever. Bone grafting of the defect may be required. C: At 6 months the fractures are united. Note the buttress plating of the shear fracture. A fibular nail has been used to stabilize the fibular fracture.