Diagnosis of a Volkmann Triangle | Volkmann Triangle

Diagnosis of a Volkmann Triangle

In the diagnostic ladder one usually starts with an anamnesis, in which the course of the accident is asked by the doctor. This is followed by a physical examination of the ankle. Here, movement restrictions and instability in the ankle may be noticed.

Afterwards, imaging is usually carried out using X-rays. In this image, the bone damage can be assessed. The Volkmann triangle is often best seen in the lateral ankle image. In order to exclude injuries to other structures such as the ligaments, an MRI is occasionally also performed. If the bony situation cannot be fully assessed by the X-ray image, a computer tomographic (CT) examination of the ankle can also be performed.

Therapy of a Volkmann Triangle

The treatment of ankle fractures with a Volkmann Triangle consists of different phases. In the acute situation of an accident, first measures after the PECH (rest, ice, compression, elevation) are useful. The current physical activity should therefore be stopped.

Then the ankle is raised, immobilized with a compression bandage or another splint and the ankle is cooled.This can counteract a pronounced swelling and also relieves the first pain. If the compression and cooling succeed in minimizing the swelling, a quick operation of the ankle joint can be performed afterwards. If the swelling is too large, one must wait a few weeks until the tissue is no longer so full of fluid.

If there is an open fracture of the ankle joint, the resulting wound must be sterilely covered in the initial treatment to prevent germs from entering the wound. A severe deformity can already be corrected by the emergency physician after administration of sedatives and painkillers. If the Volkmann Triangle is broken off in an anatomically correct position, conservative therapy can be carried out using a vacuum splint.

However, if the broken bones are displaced against each other, surgery is necessary. Depending on which bones are broken, surgery of the tibia, fibula and talus is necessary using screws, nails and plates. The Volkmann triangle itself is chipped off the tibia bone and is usually reattached with a screw.

An operation of the Volkmann Triangle is necessary in most cases. Conservative treatment can only be selected if the individual pieces of bone are in exactly the correct anatomical position against each other. There is a good chance that they will grow together without complications.

If the bones are displaced from their anatomical position, surgery is necessary. The displaced bone fragments must be brought back into the correct position. Screws, nails and plates can be used to restore the ankle structure.