Ski Boot Top Fractures
One of the worst ski injuries that can occur to the lower extremity is the ski boot top fracture. Historically, these were in the realm of podiatric foot and ankle surgeons, however with advances in ski boot technology and stiffer designs, these often end up out of our scope of practice, depending where the break happens. Either way, if you have a tibial or fibular fracture due to a ski accident, we can evaluate you at Eagle-Summit Foot & Ankle.
These injuries are traumatic fractures of the ankle or higher up at the mid-shaft of the tibia. These fractures occur as the tibia and fibula break above the top of the boot, hence the not so clever name. They almost always require surgical intervention as the tibia has the highest rate of non-union among all bones in the body. Even without injury, you can easily feel the tibia just underneath the skin of the shin; this means the bone doesn’t have the best blood supply on its own.
The location of the break will determine if we at Eagle-Summit Foot & Ankle would do the surgery or if we would send it to our orthopedic brethren. A higher up, or more proximal tibial fracture will best be repaired by a rod inserted through the knee to hold the bone in alignment. If the fracture involves the fibula and the ankle joint itself, then the surgical intervention often requires multiple plates and screws to repair the alignment of the joint. This is something we at Eagle-Summit Foot & Ankle will handle on an outpatient surgical basis.
The real severity of the injury occurs months and years later, where despite optimal treatment, the ankle joint is at significant risk of developing arthritis. Once traumatized, this joint can worsen quickly. Because of this, immediate diagnosis and definitive treatment are of utmost importance.