Ankle Fractures with Posterior Malleolar Fragment: Management and Results

Importance of Fixation of Posterior Malleolus Fracture in Trimalleolar Fractures: A Retrospective Study

“…Good clinical results were obtained compared to unaffected ankle, AOFAS assessment was excellent/good for all patients, at rate of 21/26, and mean AAOS score was 92, which is comparable to other studies of outcomes after ankle fracture. [20,21] Mean VAS pain score was 1.1 when resting and 1.3 when walking (range: 0-10), which is also comparable to the literature. [20] PM is an important structure of the distal tibiofibular joint, as it provides osseous restraint for the distal fibula as well as stability of the syndesmosis through the posterior inferior tibiofibular ligament (PITFL) and inferior transverse ligament.…”

“…[20,21] Mean VAS pain score was 1.1 when resting and 1.3 when walking (range: 0-10), which is also comparable to the literature. [20] PM is an important structure of the distal tibiofibular joint, as it provides osseous restraint for the distal fibula as well as stability of the syndesmosis through the posterior inferior tibiofibular ligament (PITFL) and inferior transverse ligament. The other important effect of stabilizing PM is to restore attached PITFL to anatomic position with appropriate tension and integrity.…”

Interobserver variation in classification of malleolar fractures

“…Due to the moderate agreement, the traditional classification systems have little value in daily use and are more relevant for research or educational purposes [12,13,23,24]. In daily practice, the integration of the number of fractured malleoli and stability of the tibiofibular syndesmosis (i.e., level of the fibular fracture) must be primary considerations in the preoperative planning and choice of treatment [25].…”

“…3 A 32-year old male with a medial malleolar fracture, possibly PA1 or PE1 fracture. Treatment does not differ [12,13,[26][27][28][29][30].…”

“…Another additional difficulty in ankle fractures is the presence and assessment of posterior malleolar fractures. Additional treatment of posterior fractures depends, according to most of the literature, on the size and dislocation of the posterior fragment [11][12][13][14]. This study compares the interobserver variation of the most commonly used ankle fracture classification systems.…”