How should ankle fractures be immobilized to avoid pressure on bony prominences?

Ankle fractures require careful immobilization to ensure proper healing and to avoid complications like pressure sores or nerve damage. The use of a well-padded splint is optimal in this scenario because it provides adequate support and stabilization for the fractured ankle while also protecting the skin and soft tissues from pressure.

Padding is crucial as it helps distribute the forces exerted on the splint evenly across the limb. This characteristic reduces the risk of causing additional injury, such as tissue necrosis or compartment syndrome, which can occur if bony prominences are subjected to direct pressure from a rigid immobilization method. Ensuring that the splint is properly padded can facilitate comfort for the patient while still maintaining alignment of the ankle and allowing for appropriate assessment of swelling and circulation.

While metal splints are sturdy, they can often be uncomfortable without cushioning and might increase the risk of pressure sores. A rigid cast offers strong immobilization but lacks the flexibility to accommodate swelling and is less forgiving regarding pressure on bony areas. Lastly, not immobilizing the fracture at all can lead to further injury or malalignment, which is not advisable for managing ankle fractures effectively. Therefore, a well-padded splint strikes the right balance between stability and comfort in this context.