Evaluation of Posterior Malleolar Fractures and the Posterior Pilon Variant in Operatively Treated Ankle Fractures

Switaj, Paul J.; Weatherford, Brian M.; Fuchs, Daniel; Rosenthal, Brett D.; Pang, Eric Quan; Kadakia, Anish R.

doi:10.1177/1071100714537630

Cited by 85 publications

(56 citation statements)

References 42 publications

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“…All these variant fractures underwent open reduction and internal fixation using either a posterolateral or a posteromedial approach, and the investigators reported satisfactory outcomes. A recent study by Switaj et al (32) reported a 20% incidence of posterior malleolus variant (termed the "posterior pilon variant") in operatively treated ankle fractures.…”

Section: Variants Of Posterior Malleolar Fracturementioning

confidence: 99%

Management of Posterior Malleolar Fractures: A Systematic Review

Odak

Ahluwalia

Unnikrishnan

et al. 2016

The Journal of Foot and Ankle Surgery

160

101

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Section: Variants Of Posterior Malleolar Fracturementioning

confidence: 99%

Management of Posterior Malleolar Fractures: A Systematic Review

Odak

Ahluwalia

Unnikrishnan

et al. 2016

The Journal of Foot and Ankle Surgery

160

101

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“…Haraguchi et al [26] in their study even included PM fractures that carried the entire medial malleolus. Switaj et al [69] and Klammer et al [41] termed the medial extension type of a fracture of the posterior rim (Haraguchi´s type II, Bartoníček´s and Rammelt´s type 3) a "posterior pilon fracture". Weber [77] considers this type as a part of trimalleolar fractures of the ankle.…”

Section: Classificationmentioning

confidence: 99%

“…Accuracy of PM reduction and quality of its fixation were postoperatively assessed on plain radiographs only, without CT follow-up. Only a few studies evaluated one particular type of PM fractures [41,69,77]. Therefore, based on the available literature, it is impossible to develop true evidence-based guidelines for the treatment of PM fractures.…”

Section: Prognosis and Complicationsmentioning

confidence: 99%

Posterior malleolar fractures of the ankle

Bartoníček

Rammelt

Tuček

et al. 2015

Eur J Trauma Emerg Surg

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Despite an increasing awareness of injuries to PM in ankle fracture-dislocations, there are still many open questions. The mere presence of a posterior fragment leads to significantly poorer outcomes. Adequate diagnosis, classification and treatment require preoperative CT examination, preferably with 3D reconstructions. The indication for surgical treatment is made individually on the basis of comprehensive assessment of the three-dimensional outline of the PM fracture and all associated injuries to the ankle including syndesmotic instability. Anatomic fixation of the avulsed posterior tibiofibular ligament will contribute to syndesmotic stability and restore the integrity of the incisura tibiae thus facilitating anatomic reduction of the distal fibula. A necessary prerequisite is mastering of posterolateral and posteromedial approaches and the technique of direct reduction and internal fixation. Further clinical studies with higher numbers of patients treated by similar methods and evaluation of pre- and postoperative CT scans will be necessary to determine reliable prognostic factors associated with certain types of PM fractures and associated injuries to the ankle.

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“…In the largest series of surgically treated ankle fractures for which fracture characteristics were reported, Switaj et al showed that 50% of the fractures involved the posterior malleolus 11 . Treating physicians must be vigilant in looking for such a fracture, as it may alter their choice of fixation method or approach.…”

Section: Ankle Fractures and Syndesmotic Injuriesmentioning

confidence: 99%