踝关节骨折

若踝关节远端有触痛或疼痛感，或在急诊室内无法负重行走，应行X线片检查。[13]Milne L. Ottawa ankle decision rules. West J Med. 1996;164:67.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1303302/pdf/westjmed00352-0069.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/8779210?tool=bestpractice.com[14]Stiell IG, Greenberg GH, McKnight RD, et al. Decision rules for the use of radiography in acute ankle injuries. Refinement and prospective validation. JAMA. 1993;269:1127-1132.http://www.ncbi.nlm.nih.gov/pubmed/8433468?tool=bestpractice.com要拍摄踝穴位（踝关节内旋15°）和侧位片。

骨折

若怀疑有内侧三角韧带损伤（平片上没有内踝骨折）时，应拍摄应力位X线片检查有无距骨外移。[20]DeAngelis NA, Eskander MS, French BG. Does medial tenderness predict deep deltoid ligament incompetence in supination-external rotation type ankle fractures? J Orthop Trauma. 2007;21:244-247.http://www.ncbi.nlm.nih.gov/pubmed/17414551?tool=bestpractice.com

单纯外踝骨折时距骨外移和合并三角韧带损伤

若骨折粉碎或累计关节面，需进行术前计划时应行CT检查。

粉碎骨折需进一步明确时

需评估踝关节周围韧带或肌腱损伤情况时可行MRI检查。

需明确韧带或肌腱损伤时