Cotton Fracture

Introduction and Purpose: Cotton Fracture; The terminology used frequently when naming

ankle fractures is called “Trimalleolar Fracture”, in fact, it is a nomenclature that does not have

an anatomical counterpart. The clinical nomenclature of fractures located in the posterior of the

tibia accompanying the malleoli of the tibia and fibula in the ankle is made in this

way. Especially in patients over 65 years of age, these fractures can be encountered quite

frequently in domestic falls, motor vehicle accidents and sports injuries. “Cotton fracture”, which

is an unstable fracture, should be treated with surgical methods.

Materials and Methods: A 56-year-old male patient came to the emergency department after

falling in the bathroom. On his arrival, his general condition was good, his GCS were 15, vitals

were stable. In his history, he described pain in her right ankle. He had no known chronic disease

and drug use. On examination, there was tenderness, swelling and deformity in the right ankle.

Neurovascular examination of the patient who had no open wound was normal. External

systemic examination was unremarkable. Fracture and accompanying tibiotalar dislocation were

observed in the medial malleolus, lateral malleolus and posterior end of the tibia in the extremity

X-ray and CT.[Figure 1-2] The patient was consulted to the Orthopedics and Traumatology

Clinic. He was discharged after recovery.

Results and Conclusion: Trimalleolar fractures are unstable and require surgical fixation.

Patients should be splinted so that the ankle joint is 90 degrees and should not carry weight.After

detection in the emergency room, patients should be consulted with the orthopedics department.