From the Guidelines
A lateral malleolus diffuse refers to swelling, inflammation, or injury affecting the lateral malleolus, which is the bony prominence on the outside of the ankle formed by the lower end of the fibula. When described as "diffuse," it indicates that the swelling or abnormality is spread out rather than concentrated in one specific spot. This condition commonly results from ankle sprains, fractures, or contusions.
Key Points to Consider
- Treatment typically includes rest, ice application for 15-20 minutes every 2-3 hours, compression with an elastic bandage, and elevation of the affected limb above heart level (RICE protocol) 1.
- Over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage pain and reduce inflammation.
- If pain is severe, persists beyond a few days, or is accompanied by inability to bear weight, significant bruising, or deformity, medical evaluation is necessary to rule out fractures or severe ligament damage.
- X-rays or other imaging may be required for proper diagnosis in these cases, following the Ottawa Ankle Rules (OAR) for guidance on when imaging is necessary 1.
Important Considerations for Diagnosis and Treatment
- The OAR are validated in children >5 years of age and should not be used in patients meeting the exclusionary criteria listed above 1.
- Typical radiographic protocols should include three standard views: anteroposterior, lateral, and mortise views to include the base of the fifth metatarsal bone distal to the tuberosity 1.
- Functional support is preferred over immobilisation, especially the use of a brace, and exercise therapy should be started as soon as possible to recover joint functionality 1.
From the Research
Lateral Malleoli Diffuse
- The term "lateral malleoli diffuse" is not directly defined in the provided studies.
- However, the studies discuss various aspects of lateral malleolar fractures, including treatment methods and stability assessment 2, 3, 4, 5.
- The studies suggest that the treatment of lateral malleolar fractures depends on the stability of the fracture, with stable fractures being treated non-operatively and unstable fractures requiring surgical intervention 3, 4, 5.
- The concept of "diffuse" is not explicitly mentioned in the context of lateral malleoli, but it could potentially refer to the distribution of force or trauma to the area, which is relevant to the discussion of fracture stability and treatment 2, 3, 4, 5.
- In contrast, a study on Morel-Lavallée lesions discusses closed degloving injuries, which can present as diffuse subcutaneous fluid collections, but this is not directly related to lateral malleoli fractures 6.