Inversion injury with a twist

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Question 1 of 3

1. Question
Considering the X rays shown, which statement would you consider to be correct:
- The images show a single fracture to the distal tibial epiphysis
- The images show a combination of epihyseal fracture, disruption of the physeal plate laterally and a spiral fracture of the lower third of the tibial shaft in addition to a fracture of the distal fibula
- The images represent a normal variant of epiphysis
- The images show a single Salter Harris II fracture of the distal tibia
- The images show a combination of spiral fracture of the distal third of the tibia and an epiphyseal fracture only
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Question 2 of 3

2. Question
Considering this type of fracture what further imaging would be most useful?
- MRI of the ankle joint
- Images of the knee joint
- CT scan of the ankle joint
- No further imaging is required
- Images of the full tibia and fibula only
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Question 3 of 3

3. Question
Regarding the management of this type of fracture, indicate which amongst these statements is correct:
- Reduction and internal fixation is contraindicated because the growth plates are not yet fully fused
- Immediate referral to the orthopaedic team for elevation in an above knee back slab is the only management needed
- Treatment with elevation and compression bandaging would suffice
- Orthopaedic closed reduction with or without further internal fixation is likely to be needed
- Treatment in a below knee back slab, crutches and referral to fracture clinic within a week is appropriate
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Inversion injury with a twist

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