Fractures of the malleoli are common. Court-Brown et al calculated an incidence of 125/100000/year. They occur equally in both sexes, but are commoner in young men and old women. They are increasingly becoming an elderly person’s osteoporotic fracture (Kannus 2002).
Most ankle fractures are low-energy twisting injuries sustained in falls, and only 1-2% are open injuries.
The evidence base that has developed, particularly over the last 20 years, gives reasonably strong guidance in several areas of practice in the care of people with ankle fractures. However, little of this is reflected in common British practice. The Hyperbook aims to explain the evidence base for the modern care of ankle fractures.