UMEM Educational Pearls - Trauma

Title: Traumatic Ankle Pain

Category: Trauma

Keywords: Ankle, Maisonneuve, Jones, Fracture (PubMed Search)

Posted: 7/14/2007 by Michael Bond, MD (Updated: 5/13/2026)
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Traumatic Ankle Pain When examining a patient who presents with Ankle Pain, make sure that you examine/palpate the proximal fibula and the base of the fifth metatarsal. Pain over the proximal fibula will necessitate a full Tibia/Fibula x-ray to rule out a Maisonneuve Fracture [a proximal fracture of fibula resulting from external rotation; injury may occur with medial or posterior malleolus fracture, a ligament rupture, as well as rupture of interosseous membrane. Pain over the base of the 5th metatarsal suggests a Jones Fracture [ involves fx at base of fifth metatarsal at metaphyseal-diaphyseal junction, which typically extends into the 4-5 intermetatarsal facet; is located w/in 1.5 cm distal to tuberosity of 5th metatarsal & should not be confused w/ more common avulsion fx (Dancer s Fracture) of 5th metatarsal styloid]

Title: Injury score comparable geriatric vs non-geriatric patients: Over 65 years do much worse

Category: Trauma

Keywords: geriatric, trauma, orthopedic injury, injury severity score (PubMed Search)

Posted: 11/5/2022 by Robert Flint, MD (Updated: 12/9/2022)
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Trauma patients over age 65 should be cared for by a multidisciplinary trauma team. Here is another study affirming that patients over age 65 do worse when having similar injuries to those under 65. Interestingly, those under 65 had more operative repairs of their orthopedic injuries as well.  

The authors conclude: “Although the ISS and NISS were similar, mortality was significantly higher among patients aged ≥ 65 years compared to patients < 65 years of age”.

 Also it bears further investigation of why those under 65 received more operative repairs

 

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