Description
In this Hunterian Lecture, Lyndon Mason, a renowned foot and ankle surgeon from Liverpool, presents an in-depth exploration of posterior malleolar fractures, a topic he has devoted significant research to over the last five years. Mason emphasizes the importance of scientific inquiry in medical practice, reflecting on the legacy of John Hunter, an advocate for meticulous observation and research in medicine. The lecture unfolds a critical audit conducted at Aintree University Hospital, revealing a concerning rate of complications resulting from ankle fracture surgeries, which prompted a re-evaluation of surgical techniques and educational practices within the department.
Mason discusses the common misconceptions and dogmatic beliefs surrounding the treatment of ankle fractures, particularly the outdated notion that only fractures larger than a third require surgical intervention. He asserts the necessity of addressing even small fragments, as radiographs often fail to accurately convey the true extent of injuries, and he advocates for the use of CT scans in diagnosing posterior malleolar fractures.
Throughout the lecture, Mason outlines various injury classifications and their distinct treatment approaches, challenging traditional methods and sharing evidence of improved outcomes through modern techniques, including the posteromedial approach for accessing fractures. He concludes by reinforcing the notion that size does not inherently dictate the severity of injury or the need for surgery, emphasizing the relationship between fracture mechanism and management strategies. The lecture is rich with clinical insights and a call for continued research and adaptation in orthopedic practices, aiming to enhance patient outcomes in complex ankle injuries.