Treatment of Ankle Fracture: Initial First-Line Management
Ankle fractures require prompt evaluation of pain severity and limb alignment. First-line management addresses analgesia, deformity correction when present, and fracture stabilisation.
Clinical focus
This protocol covers the initial approach to an ankle fracture, encompassing pain assessment, the decision on urgent reduction for deformed ankles, and appropriate immobilisation with limb elevation.
Treatment approach
Management is guided by pain severity: oral analgesics are used for milder presentations, while severe pain calls for parenteral options. Clinically deformed ankles require urgent intervention before stabilisation.
The complete regimen — including specific agents, sequencing for each pain tier, cast and splint protocol, and follow-up imaging — is available in the full structured protocol.
References
DOI: 10.1177/1750458920988162
- Oral paracetamol should be offered for mild pain, oral paracetamol and codeine for moderate pain and intravenous (IV) paracetamol with IV morphine titrated to effect for severe pain.
- Clinically deformed ankles require urgent reduction and splinting.
- Any fracture should be stabilised in a well-fitted backslab cast or splint, with the limb elevated and a post-reduction X-ray arranged to confirm adequate alignment.
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