Acute pain management
Open fractures require immediate IV antibiotics and urgent surgical washout
Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
Consider risk for compartment syndrome
Determined by stability of fracture:
Stable, nondisplaced, isolated malleolar fracture: Splint or cast, early wt bearing, RICE
Unstable or displaced fracture: Requires ORIF, ortho consult, reduce and splint
Stable, nondisplaced, isolated malleolar fracture: Splint or cast, early wt bearing, RICE
Unstable or displaced fracture: Requires ORIF, ortho consult, reduce and splint
If stable (see Weber classification) treat like severe<unk>  Sprain
Signs of instability:
Displacement >3mm
Associated medial malleolus fracture
Signs of medial (deltoid) ligament disruption such as medial swelling, ecchymosis, or TTP
Widening of medial clear space (suggests deltoid ligament injury)
Displacement >3mm
Associated medial malleolus fracture
Signs of medial (deltoid) ligament disruption such as medial swelling, ecchymosis, or TTP
Widening of medial clear space (suggests deltoid ligament injury)
Must rule-out other injuries
If non-displaced, isolated:
Short-Leg Posterior Splint<unk>  at 90o)
Non-weight bearing
Refer to Ortho in 5-7d
Short-Leg Posterior Splint<unk>  at 90o)
Non-weight bearing
Refer to Ortho in 5-7d
Short-Leg Posterior Splint<unk>  at 90o)
Immediate reduction or ortho consult in ED
Ankle fracture
Ankle sprain
Humerus fracture
Ankle dislocation
Femur fracture 
Ankle syndesmosis injury
Femur fracture
Radiograph-negative ankle injury 