Thus, it is usually the responsibility of the executive branch to efficiently implement and enforce the laws passed by the legislative branch. The executive branch is ultimately accountable to the legislative and judicial branches for its actions and policies.
A bimalleolar fracture most commonly means that the lateral malleolus and the medial malleolus are broken and the ankle is not stable. Usually surgery is indicated to help stabilize the lower extremity.
Treat these injuries as a bimalleolar fracture, and refer patients with this injury for treatment by an orthopedist. Referral is also indicated for all trimalleolar fractures, which involve fracture to both the medial and lateral malleoli, along with a fracture to the posterior lip of the tibial plafond.