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1

Wong, Liam H., Lara C. Atwater, and Alden E. Wyland. "Impact of Obesity on Severity of Ankle Fracture." Foot & Ankle Orthopaedics 7, no. 4 (2022): 2473011421S0100. http://dx.doi.org/10.1177/2473011421s01005.

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Category: Trauma; Ankle Introduction/Purpose: Ankle fractures are one of the most common types of foot and ankle trauma requiring surgery. Prior studies have investigated the association between obesity and ankle fracture on a general level, but not all studies have broken down the data by ankle fracture pattern subtypes. The aim of this study was to investigate the association between obesity and severity of ankle fractures, as classified by single malleolar (isolated fibular, posterior malleolar or medial malleolar), bimalleolar, trimalleolar and pilon subtypes. Methods: We retrospectively i
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Kumar, Ashwani, Puneet Mishra, Anupama Tandon, Rajesh Arora, and Manish Chadha. "Effect of CT on Management Plan in Malleolar Ankle Fractures." Foot & Ankle International 39, no. 1 (2017): 59–66. http://dx.doi.org/10.1177/1071100717732746.

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Background: Conventionally ankle fractures have been classified using plain radiographs. Because of complex 3-dimensional anatomy and complexity of injuries, plain radiographs may not always be able to clearly depict the complete fracture pattern. There is a paucity of studies regarding the utility of computed tomography (CT) scanning in malleolar ankle fractures (MAFs). Hence, we conducted this study to further understand the role of the CT scan in MAFs. Methods: A prospective study of 56 consecutive malleolar ankle fractures was conducted. In the first evaluation by a team of 3 observers, a
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Ullah, Najeeb, Baryalai Khan, Asad Moiz Hussain, Muhammad Shoib, Khushal Khan Kakar, and Sana Ullah Kakar. "Comparison of Adequacy of Reduction of Third Malleolar Fracture in Prone vs. Spine Position in Tri-Malleolar Ankle Fracture a Tertiary Care Experience." Pakistan Journal of Medical and Health Sciences 18, no. 6 (2024): 37–39. http://dx.doi.org/10.53350/pjmhs020241869.

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Background: Ankle fractures, especially tri-malleolar fractures, are among the most frequent injuries to the lower extremities, affecting about 179 out of 100,000 individuals each year. Because of their complexity, these fractures provide serious complications for orthopedic surgeons. This work therefore analyzes tri-malleolar fractures to know the effect of prone position in relation to supine position while at the same time bearing in mind the characteristics of individual fracture, the surgeon and the patient. Methods: This comparative study was conducted at a tertiary care hospital, involv
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Finney, Fred, Andrew Kuhn, Shahin Sheibani-Rad, Paul Charpentier, James Holmes, and Asheesh Bedi. "Outcomes Following Nonoperative Treatment of Isolated Posterior Malleolar Ankle Fractures." Foot & Ankle Orthopaedics 2, no. 3 (2017): 2473011417S0001. http://dx.doi.org/10.1177/2473011417s000169.

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Category: Ankle, Trauma Introduction/Purpose: Ankle fractures are common injuries, however isolated posterior malleolar fractures are rare. Axial loading of the foot in hyper-plantarflexion is thought to be the most likely mechanism of injury for this fracture pattern. Management of isolated posterior malleolar fractures presents challenges for clinicians, and controversy exists over surgical indications. The literature to-date examining isolated posterior malleolar fractures is scarce and confined to case reports and small clinical series. Recommendations for surgical treatment are based larg
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Rammelt, Stefan, Livia Kroker, Annika Pauline Neumann, and Jan Bartonicek. "Anterior Malleolar Fractures: Pathoanatomy, Classification and Treatment Options." Foot & Ankle Orthopaedics 7, no. 4 (2022): 2473011421S0089. http://dx.doi.org/10.1177/2473011421s00891.

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Category: Trauma; Ankle Introduction/Purpose: The anterior distal tibial tubercle (Tillaux-Chaput tubercle) frequently fractures in the wake of malleolar fractures. It provides attachment to the anterior tibiofibular syndesmosis and may be considered a fourth or anterior malleolus (AM). In analogy to posterior malleolar fractures, AM fractures may extend into the tibial incisura and tibial plafond. We analyzed the pathoanatomy of AM fractures and associated injuries in ankle fractures in adults. Methods: Over a course of 9 years, 140 patients (average age 58.3 years) with 140 acute malleolar f
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Carter, T. H., A. D. Duckworth, and T. O. White. "Medial malleolar fractures." Bone & Joint Journal 101-B, no. 5 (2019): 512–21. http://dx.doi.org/10.1302/0301-620x.101b5.bjj-2019-0070.

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The medial malleolus, once believed to be the primary stabilizer of the ankle, has been the topic of conflicting clinical and biomechanical data for many decades. Despite the relevant surgical anatomy being understood for almost 40 years, the optimal treatment of medial malleolar fractures remains unclear, whether the injury occurs in isolation or as part of an unstable bi- or trimalleolar fracture configuration. Traditional teaching recommends open reduction and fixation of medial malleolar fractures that are part of an unstable injury. However, there is recent evidence to suggest that nonope
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Tartaglione, Jason, Sorawut Thamyongkit, Pooyan Abbasi, Brent Parks, Erik Hasenboehler, and Lew Schon. "Early Weightbearing After Operatively Treated Trimalleolar Ankle Fractures with Large Posterior Malleolar Fragments." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0047. http://dx.doi.org/10.1177/2473011418s00478.

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Category: Trauma Introduction/Purpose: No consensus exists regarding postoperative rehabilitation protocols after surgical fixation of unstable trimalleolar ankle fractures with large posterior malleolar fragments. Additionally, no consensus exists regarding type of fixation of large posterior malleolar fragments in these fractures. It is unclear whether clinical results with early weightbearing differ between large posterior malleolar fragments fixed with either screws alone or a plate and screws construct. We evaluated fracture displacement with simulated early weightbearing in a cadaveric m
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8

Gawali, Satish R., Raman O. Toshniwal, Shashikant B. Kukale,, and Pramod V. Nirvane,. "Management of Fracture of Posterior Malleolus, Trimalleolar Fracture, Fracture Dislocations, and Syndesmosis Injury of Ankle Joint." Journal of Foot and Ankle Surgery (Asia Pacific) 4, no. 2 (2017): 90–96. http://dx.doi.org/10.5005/jp-journals-10040-1077.

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ABSTRACT Background Malleolar fractures of ankle are usually complex injuries, as they are associated with significant ligament and soft tissue injury—injury to syndesmosis and injury to medial and lateral collateral ligaments. The open reduction and internal fixation is not feasible until recovery of significant soft tissue injury and subsidence of edema. Malleolar fractures are articular fractures and have associated subluxation and dislocation of talus. The aims of treatment are to restore normal anatomy and provide sufficient stability for early movements. Malleolar fractures more often re
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9

Malik, Azeem Tariq, Safdar N. Khan, Laura Phieffer, Thuan V. Ly, and Carmen E. Quatman. "Are Orthopaedic Surgeons Being Adequately Compensated for Ankle Fractures? An Analysis of Relative Value Units (RVUs)." Foot & Ankle Orthopaedics 4, no. 4 (2019): 2473011419S0005. http://dx.doi.org/10.1177/2473011419s00052.

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Category: Ankle, Trauma Introduction/Purpose: Tri-malleolar fractures, as compared to simple uni-malleolar fractures, are technically more challenging cases, have longer operative times and require a higher effort. The current RVU-based system is built to reflect the varying presentation of ankle fractures (uni-malleolar vs. bi-malleolar vs. tri-malleolar) by assigning individual RVUs to different fracture complexities. However, no study has evaluated whether the current RVUs reflect an appropriate compensation per unit time following open reduction internal fixation (ORIF) for uni-malleolar v
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Miller, Matthew A., Tyler C. McDonald, Matthew L. Graves, et al. "Stability of the Syndesmosis After Posterior Malleolar Fracture Fixation." Foot & Ankle International 39, no. 1 (2017): 99–104. http://dx.doi.org/10.1177/1071100717735839.

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Background: We sought to define the rate of syndesmotic instability after anatomic reduction of the posterior malleolus when posterior stabilization of a trimalleolar or trimalleolar equivalent ankle fracture was chosen vs when a supine position and initially conservative management of the posterior elements was chosen. Methods: The types of syndesmotic and posterior malleolar fixation used to treat adult patients with ankle fractures involving the posterior malleolus at our level I trauma center were retrospectively assessed (N = 198). Specifically, both bimalleolar and trimalleolar fractures
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11

Kapadia, Shubham S., Parag P. Dangi, Aumkar H. Pandya, Sarvang M. Desai, and Paresh P. Golwala. "Study of clinical and functional outcome of malleoli fracture." International Journal of Research in Orthopaedics 10, no. 6 (2024): 1246–52. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20243118.

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Background: Ankle fractures are a common orthopedic injury, accounting for 9% of all fractures, with an increasing incidence among both young and elderly populations. These fractures often result from road traffic accidents, falls, and sports injuries. Malleolar fractures, involving the bony prominences of the ankle, are particularly prevalent and necessitate accurate reduction and stable internal fixation to prevent complications such as post-traumatic arthritis and restricted motion. This study aims to assess the functional outcomes and results of surgical treatment of malleolar fractures. M
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Rammelt, Stefan, Livia Kroker, and Annika P. Neumann. "Quadrimalleolar Fractures of the Ankle: Principles and Medium-Term Results of Surgical Fixation." Foot & Ankle Orthopaedics 7, no. 1 (2022): 2473011421S0041. http://dx.doi.org/10.1177/2473011421s00410.

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Category: Ankle; Trauma Introduction/Purpose: Over the last decade, much attention has been paid to the fractures of the posterior malleolus as it became obvious that the mere presence of a posterior tibial fragment is associated with a less favorable prognosis in malleolar fractures. It seems logical to pay the anterior restraints of the ankle joint a similar attention as to the posterior ones. The anteriolateral distal tibia may be considered a 'fourth' or anterior malleolus. Here, we present a technique of fixation of trimalleolar fractures with additional fracture of the anterior tibial tu
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13

Barchick, Stephen, Samuel Adams, and Andrew Matson. "Medial Malleolus Fracture Fixation in the Setting of Concomitant Tibial Shaft Fractures." Foot & Ankle Orthopaedics 2, no. 3 (2017): 2473011417S0001. http://dx.doi.org/10.1177/2473011417s000106.

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Category: Ankle, Trauma Introduction/Purpose: The association between tibial shaft fractures and concomitant posterior malleolus fractures has been well-studied; however less is known about tibial shaft fractures and concomitant medial malleolus fractures. Treatment of tibial shaft fractures with a plate or intramedullary nail in the setting of concomitant medial malleolus fracture may pose obstacles to standard medial malleolus fractures fixation due to hardware that impedes optimal screw placement. The purpose of this study is to report the presentation and management strategies used to trea
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Lee, Gi-Soo, Chan Kang, Byung-Ki Cho, and Yougun Won. "Screw fixation of the posterior malleolar fracture." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0030. http://dx.doi.org/10.1177/2473011418s00306.

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Category: Trauma Introduction/Purpose: Posterior malleolar fracture is known to be an indication for surgery when the size of the fragment is greater than 25% to 30% of the joint surface. The purpose of this study was to compare the results of cannulated screw fixation and early joint motion in patients with ankle fracture with posterior malleolar fracture of less than 25%, and we do cadaver experiments. Methods: The clinical portion of the study evaluated 70 patients with fracture of the posterior malleolus that comprised less than 25% of the articular surface. After fixation for lateral and/
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15

Warner, Stephen J., Elizabeth B. Gausden, Ashley E. Levack, and Dean G. Lorich. "Supination External Rotational Ankle Fracture Injury Pattern Correlation With Regional Bone Density." Foot & Ankle International 40, no. 4 (2018): 384–89. http://dx.doi.org/10.1177/1071100718816680.

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Background: Rotational ankle fractures can present with an array of possible osseous and ligamentous injury combinations in reliable anatomic locations. What accounts for these different injury patterns and whether specific patient and injury factors underlie the different injury patterns is unclear. The purpose of this study was to determine whether causative factors exist that could account for the various injury patterns seen with rotational ankle fractures. Methods: A registry of operatively treated supination external rotation stage IV (SER IV) ankle fractures was used to identify patient
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Feng, Yao, Jing Niu MD, Jun Jiang MD, Li Shen MD, and Jike Lu MD,PhD. "Posterior Malleolus Fractures in Trimalleolar Ankle Fractures: Is Transyndesmotic Fixation Necessary?" Journal of Clinical Medicine 10, no. 1 (2025): 1–12. https://doi.org/10.52338/tjocm.2025.4610.

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Posterior malleolus (PM) fracture in trimalleolar fractures is closely associated with syndesmosis stability and affecting functional outcomes in comparison to bimalleolar fractures of the lateral and medial malleolus. The purpose of this study was to explore the role of posterior malleolus fixation for maintaining of the distal tibiofibular joint stability and intermediate-term outcomes on functional recovery and radiological appearances. In the last 7 years (2015-2022) we did ORIF for 98 consecutive trimalleolar ankle fractures which were evaluated retrospectively in patients with and withou
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Dr., Nabil Zunayed Sidny. "Evaluation of Outcome of Surgical Management of Ankle Fracture (Medial Malleolus) by Single Swiss Malleolar Screw." International Journal of Medical and Pharmaceutical Research 4, no. 3 (2023): 120–25. https://doi.org/10.5281/zenodo.7937867.

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<strong>Introduction: </strong>Ankle fractures are common orthopedic injury. These fractures involve medial and lateral malleolus with sometimes posterior malleolus. Ankle fracture may range from low energy injuries with little or no displacement to complex fractures with significant associated injuries. Stability of these injuries depends on a combination of boney and associated ligamentous injuries. <strong>Objective:</strong> To assess the evaluation of outcome of surgical management of ankle fracture (medial malleolus) by single swiss malleolar screw. <strong>Methods: </strong>This prospec
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Liu, Yijun, Hao Lu, Hailin Xu, et al. "Characteristics and classification of medial malleolar fractures." Bone & Joint Journal 103-B, no. 5 (2021): 931–38. http://dx.doi.org/10.1302/0301-620x.103b5.bjj-2020-1859.r2.

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Aims The morphology of medial malleolar fracture is highly variable and difficult to characterize without 3D reconstruction. There is also no universally accepeted classification system. Thus, we aimed to characterize fracture patterns of the medial malleolus and propose a classification scheme based on 3D CT reconstruction. Methods We retrospectively reviewed 537 consecutive cases of ankle fractures involving the medial malleolus treated in our institution. 3D fracture maps were produced by superimposing all the fracture lines onto a standard template. We sliced fracture fragments and the sta
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Adébola, Padonou, Goukodadja Oswald, Attolou S.Gilles, et al. "Outcomes of Malleolar Fracture Osteosynthesis in Cotonou: A Review of 31 Cases." SAS Journal of Surgery 8, no. 2 (2022): 65–67. http://dx.doi.org/10.36347/sasjs.2022.v08i02.006.

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Introduction: Malleolar fractures are joint lesions which are instable in most cases, cause the disorganization of ankle clamp and require operational treatment. This study aims to assess the morphological and functional outcomes of malleolar fracture osteosynthesis in our work settings characterized by limited resources. Methodology: This is A five-year retrospective involving 31 individuals treated using surgical procedures and who benefited of close follow-up on in the postoperative period. The anatomical assessment was based on the Lecestre and Ramadier criteria whereas the functional eval
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Duan, Xiaojun, and Anish R. Kadakia. "Operative Treatment of Posterior Malleolar Fractures." Open Orthopaedics Journal 11, no. 1 (2017): 732–42. http://dx.doi.org/10.2174/1874325001711010732.

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Fractures of the posterior malleolus can occur in conjunction with fibular and medial malleolar fractures or in isolation. The indications for fixation of the posterior malleolus remain controversial except for the fragment sizes. A number of different surgical approaches and techniques for internal fixation of posterior malleolar fractures have been reported. Newer techniques such as direct exposure and plating of the posterior malleolus are chosen more frequently than traditional techniques of indirect reduction and percutaneous screw fixation. These attributes help to minimize the occurrenc
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Deore, Sandeep, Sachin Kale, Sunil Shetty, Ajit Chalak, Rohan Jayaram, and Roonam Patir. "A Novel Approach to Medial Malleolus Fracture of Ankle using Adjustable Loop Suspensory Fixation." Journal of Clinical Orthopaedics 9, no. 2 (2024): 132–36. https://doi.org/10.13107/jcorth.2024.v09i02.698.

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Medial malleolar fractures are traditionally treated by orthopaedic surgeons using cancellous screws, plates, and tension banding with stainless steel wires. However, a considerable proportion of these patients eventually require revision surgery or implant removal due to complications such as wire migration, impingement, breakage, and infection. Revision surgeries for previously operated malleolar fractures pose challenges due to dilated bone tracks and osteopenia which complicate securing the mechanical hold of the implant. A potential solution to mitigating these factors could be the use of
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Bäcker, Henrik C., Matthew Konigsberg, Christina E. Freibott, Melvin P. Rosenwasser, Justin K. Greisberg, and J. Turner Vosseller. "Radiographic Results of Unicortical Medial Malleolar Fracture Fixation." Foot & Ankle International 40, no. 4 (2018): 398–401. http://dx.doi.org/10.1177/1071100718816692.

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Background: Medial malleolar fractures commonly occur as part of rotational ankle fractures, which often require surgery. Different fixation techniques exist, including unicortical or bicortical lag-screw fixation. Bicortical screws that engage the lateral distal tibia have been noted to be biomechanically superior to unicortical ones with a lower failure rate. The authors of this study have used unicortical screws routinely. This study was initiated to investigate the clinical results of a large series of patients with unicortical medial malleolar fixation. Methods: Patients who underwent uni
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Handolin, L., V. Kiljunen, I. Arnala, et al. "No Long-Term Effects of Ultrasound Therapy on Bioabsorbable Screw-Fixed Lateral Malleolar Fracture." Scandinavian Journal of Surgery 94, no. 3 (2005): 239–42. http://dx.doi.org/10.1177/145749690509400312.

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Background and Aims: The present study was initiated to evaluate the long-term effects of low-intensity ultrasound therapy on bioabsorbable screw-fixed lateral malleolar fractures, which has not been studied earlier. Patients and Methods: The study design was prospective, randomized, double-blinded, and placebo-controlled. Sixteen dislocated lateral malleolar fractures were fixed with one bioabsorbable self-reinforced poly-L-lactide screw. The patients used an ultrasound device 20 minutes daily for six weeks without knowing it was active (eight patients) or inactive (eight patients). The follo
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S, Ashik Narayan, and Rejani H. "INDIAN PLASTERING TECHNIQUE IN MALLEOLAR FRACTURES." December 2020 8, no. 12 (2020): 5207–13. http://dx.doi.org/10.46607/iamj0208122020.

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Ankle is the most common site where a lower limb fracture can occur. Ankle joint fracture can occur during sports activities and misstep on daily routine. Ankle joint fracture caused by an indirect trauma is about 9% of all other fractures. As far as the modern conservative management is concerned, a below knee plaster for a period of 3-6 weeks is sufficient enough to protect the fractured ankle joint without displacement. This type of plastering technique may cause some complications like muscle atrophy, cartilage degeneration, and a stiff, painful and swollen joint. Hence, an Ayurvedic appro
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Mason, Lyndon, Lara Jayatilaka, Andrew Fisher, Lauren Fisher, and Andrew Molloy. "Anatomy of the Insertion of the Posterior Inferior Tibiofibular Ligament and the Posterior Malleolar Fracture." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0034. http://dx.doi.org/10.1177/2473011418s00341.

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Category: Ankle Introduction/Purpose: The treatment of posterior malleolar fractures is developing. Our previous study on the anatomy of the posterior malleolar fracture identified only 49% of rotational push off fractures of the posterior malleolus had syndesmotic instabilities. This was against general thinking that fixation of such a fragment would stabilize the syndesmosis. Our aim in this study was to identify the extent of the posterior inferior tibiofibular ligament insertion on the posterior tibia and its relation to push off fractures. Methods: We examined 10 cadaveric lower limbs tha
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Ali, Khandoker Muhammud Mazher, Muhammad Mozaherul Islam, K. M. Badar Uddin, M. Rukanuddawla Khan, and M. Atikur Rahman Shojib. "Comparison of American orthopedic foot and ankle society score between anterior to posterior lag screws versus posterior buttress plating for posterior malleolus fixation in tri-malleolar ankle fracture." International Journal of Research in Orthopaedics 10, no. 1 (2023): 24–28. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20234036.

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Background: Posterior malleolar fractures are frequent, occurring in up to 44% of all ankle fractures. Surgical management typically involves anterior to posterior (AP) lag screws or posterior buttress plates. This study aimed to compare the AOFAS (American orthopedic foot and ankle society) score between AP lag screw and posterior buttress plating for posterior malleolus fixation in tri-malleolar ankle fracture. Methods: This quasi-experimental study was conducted at the department of orthopedics and traumatology, Chittagong medical college hospital, Chattogram, Bangladesh, from November 2020
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Bua, Nelson, Luckshmana A. Jeyaseelan, Lee Parker, et al. "Outcomes of Posterior Malleolar Fixation in Ankle Fractures in A Major Trauma Centre." Foot & Ankle Orthopaedics 7, no. 1 (2022): 2473011421S0012. http://dx.doi.org/10.1177/2473011421s00121.

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Category: Ankle; Trauma Introduction/Purpose: Ongoing controversy exists over the indications and benefits of posterior malleolar fixation in ankle fractures. These injuries require careful evaluation of the bony and ligamentous structures with theoretical benefits of posterior malleolar fixation now widely accepted as restoration of articular congruity, restoration of fibular length and stabilisation of the syndesmosis. Surgical and patient report outcomes are varied in the literature with analysis limited by the lack of standardisation in functional outcomes and small patient populations. Po
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Yang, Yunfeng, Wenbao He, Haichao Zhou, Jiang Xia, Bing Li, and Tao Yu. "Combined Posteromedial and Posterolateral Approaches for 2-Part Posterior Malleolar Fracture Fixation." Foot & Ankle International 41, no. 10 (2020): 1234–39. http://dx.doi.org/10.1177/1071100720937637.

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Background: This study investigated the clinical efficacy of combined posteromedial and posterolateral approaches for repair of 2-part posterior malleolar fractures associated with medial and lateral malleolar fractures. Methods: This case series report included 27 Weber B with Haraguchi type II patients with medial and lateral malleolar fractures combined with 2-part posterior malleolar fractures. Patients were treated with open reduction and internal fixation through a combination of posteromedial and posterolateral approaches from January 2015 to January 2018. There were 11 males and 16 fem
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Wang, Zhifeng, Chengjie Yuan, Genrui Zhu, et al. "A Retrospective Study on the Morphology of Posterior Malleolar Fractures Based on a CT Scan: Whether We Ignore the Importance of Fracture Height." BioMed Research International 2020 (July 30, 2020): 1–8. http://dx.doi.org/10.1155/2020/2903537.

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Objective. The aim of this study was to investigate the respective correlation between the height (H) of a posterior malleolar fracture (PMF) and the involved area (S) of an articular surface and the presence of “die-punch.” Methods. Patients with closed posterior malleolar fractures admitted to our hospital from January 2015 to December 2017 were selected, with complete X-ray and 3D reconstruction CT imaging data. The gender, age, injured side, and surgical fixation methods of the patients were recorded. A preoperative ankle CT scan was performed, and the images were viewed through the PACS (
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Gaurav, Agarwal, Khare Harshit, and Jain Gaurav. "Clinical Study to Evaluate the Outcome of Conservatively Managing the Posterior Malleolus Fracture in a Trimalleolar Ankle Fracture." International Journal of Toxicological and Pharmacological Research 13, no. 11 (2023): 82–85. https://doi.org/10.5281/zenodo.10996860.

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<strong>Background:&nbsp;</strong>Ankle fractures are one of the most common lower limb injuries, accounting for about 9 % of all fractures.&nbsp; The incidence of ankle fracture is roughly 187 cases per 1 lac people each year, out of which 7-11% constitutes the Trimalleolar ankle fracture. [1] The treatment of the posterior malleolus still remains controversial as to when to fix it and when to conservatively manage it, if at all. This Clinical study aimed at assessing the functional outcome of conservatively managing the posterior malleolar fragment of Trimalleolar ankle fractures based on fu
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Maniar, Hemil, Harish Kempegowda, Akhil A. Tawari, et al. "Medial Malleoli Fractures: Clinical Comparison Between Newly Designed Sled Device and Conventional Screws." Foot & Ankle Specialist 10, no. 4 (2016): 296–301. http://dx.doi.org/10.1177/1938640016677809.

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Background. The Trimed Medial Malleolar Sled is a newer device designed to treat medial malleolus fracture. The purpose of this study was to compare the outcome of medial malleolar fractures treated with the sled and conventional malleolar screws. Methods. After obtaining an institutional review board approval, we conducted a retrospective study to identify all skeletally mature patients who sustained an ankle fracture with medial malleolar involvement treated with the sled and we identified a matched cohort treated with conventional malleolar screws. The patients were divided into 2 groups: g
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Mursalov, Nagmet, and Kazybek Baktybergen. "An Uncommon Ankle Injury: Maisonneuve Fracture Case Report." Traumatology and Orthopаedics of Kazakhstan 66, no. 1 (2023): 40–44. http://dx.doi.org/10.52889/1684-9280-2023-1-66-40-44.

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Maisonneuve fracture is a rare and complex ankle fracture characterized by a triad of injuries, including a medial malleolar fracture, injury to the inferior tibiofibular syndesmotic complex, and a proximal fibula fracture. This case report presents the case of a 53-year-old female who sustained a Maisonneuve fracture following a fall on the stairs. Physical examination revealed tenderness and swelling in the left ankle, and radiographs confirmed fractures of the medial and posterior malleolus of the left ankle. Despite receiving conservative treatment in the form of a plaster cast, the patien
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Jayatilaka, Malwattage Lara Tania, Matthew D. G. Philpott, Andrew Fisher, Lauren Fisher, Andrew Molloy, and Lyndon Mason. "Anatomy of the Insertion of the Posterior Inferior Tibiofibular Ligament and the Posterior Malleolar Fracture." Foot & Ankle International 40, no. 11 (2019): 1319–24. http://dx.doi.org/10.1177/1071100719865896.

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Background: Our aim in this study was to identify the extent of the posterior inferior tibiofibular ligament (PITFL) insertion on the posterior tibia and its relation to intra-articular posterior malleolar fractures. Methods: Careful dissection was undertaken on 10 cadaveric lower limbs to identify the ligamentous structures on the posterior aspect of the ankle. The ligamentous anatomy was further compared with our ankle fracture database, specifically posterior malleolar fracture patterns, demonstrating a rotational pilon etiology (Mason and Molloy type 2A and B). Computed tomography imaging
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Yearson, Diego, Ignacio Melendez, Federico Anain, Santiago Siniscalchi, and Juan Drago. "Posterior malleolar fractures. New classification and treatment algorithm." Journal of the Foot & Ankle 14, no. 3 (2020): 254–59. http://dx.doi.org/10.30795/jfootankle.2020.v14.1199.

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Objective: This study proposes a new classification of posterolateral malleolar fractures and a treatment algorithm. Methods: We divided the posterolateral malleolus, which we considered as the posterior malleolus, from the posteromedial one, which we considered as being part of the medial malleolus fracture. The experience with 77 patients treated from February 2017 to February 2020 was assessed. All of them were assessed by frontal and profile radiographies and computed tomography (CT). Among the parameters to classify these fractures, we believe the most determining ones are fracture size,
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Ghaffari, Salman, Masoud Shayesteh Azar, Mohammad Hossein Kariminasab, Tahereh Ranjbar, and Bahman Ghaffari. "The frequency of proximal tibiofibular joint types in patients with malleolar fractures." Bangladesh Journal of Medical Science 17, no. 4 (2018): 625–30. http://dx.doi.org/10.3329/bjms.v17i4.38326.

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Background: Due to the prevalence of ankle malleolar fractures and by considering the influence of proximal tibiofibular joint(PTFJ) on fibula movement during ankle motion and subsequently on ankle injuries, this research was conducted to determine distributed frequency of the PTFJ in adult patients with malleolar fractures.Methods: This survey was conducted on a prospective cross-sectional basis. adult patients with malleolar fractures in two year period enrolled . Information, such as gender, age, mechanisms of fractures, reason of fractures, location of fractures was Collected, classified a
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BAUER, MATS, BJ??RN BERGSTR??M, ANDERS HEMBORG, and JAN SANDEG??RD. "Malleolar Fractures." Clinical Orthopaedics and Related Research &NA;, no. 199 (1985): 17???27. http://dx.doi.org/10.1097/00003086-198510000-00004.

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Cansü, Eren, Mehmet B. Unal, Serkan Gurcan, and Fatih Parmaksizoglu. "Surgical Treatment of Lateral Malleolar Fractures Using the Compression Cerclage System." Journal of the American Podiatric Medical Association 106, no. 5 (2016): 313–18. http://dx.doi.org/10.7547/14-110.

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Background Lateral malleolar fractures (Weber type B or OTA 44-B) account for 60% of all ankle fractures. To achieve anatomic restoration, surgical stabilization provides better results than conservative treatment. Various fixation methods are available to treat these fractures; however, the best method is still unknown. Our objectives were to present a new, useful, and efficient surgical technique for stabilizing lateral malleolar fractures and to analyze the outcomes of patients treated with the compression cerclage system. Methods The surgical technique consists of a Kirschner wire that is
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Taki, Masanori, and Naohiro Hio. "The Lateral Trans-Malleolar approach for Posterior Malleolar Fracture of the Ankle: A Clinical and Computed Tomography Evaluation." Foot & Ankle Orthopaedics 5, no. 4 (2020): 2473011420S0046. http://dx.doi.org/10.1177/2473011420s00463.

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Category: Ankle; Trauma Introduction/Purpose: Posterior malleolar fracture reduction including the articular surface of trimalleolar ankle fracture has been reported to be an important prognostic factor. The lateral trans-malleolar approach (LTA) is a surgical approach that provides direct visualization of the articular surface of the posterior malleolus. We herein report the clinical results and computed tomography (CT) findings for the articular reduction status after LTA for posterior malleolar fracture of the ankle. Methods: Sixteen patients (9 men, 7 women, mean age 52.6+-18.1 years old)
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Kor, Alex, Andrew T. Saltzman, and Patrick D. Wempe. "Medial Malleolar Stress Fractures." Journal of the American Podiatric Medical Association 93, no. 4 (2003): 292–97. http://dx.doi.org/10.7547/87507315-93-4-292.

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Medial malleolar stress fractures are relatively uncommon injuries that can be quite debilitating and disabling. This article discusses the symptoms, diagnostic aids, pathomechanics, and management of medial malleolar stress fractures. Using three cases, the authors illustrate nonoperative versus operative treatments in an athlete and the influence of an in-season versus an off-season injury. A percutaneous cannulated screw fixation procedure is described that allowed an athlete to return to competition 24 days after sustaining a displaced medial malleolar stress fracture. (J Am Podiatr Med As
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Pyle, Leslie H., Raed W. Al-Gharib, and Erik C. Kissel. "Lateral Malleolar Fracture with Concurrent Achilles Tendon Rupture: A Case Report and Literature Review." Case Reports in Emergency Medicine 2020 (February 11, 2020): 1–4. http://dx.doi.org/10.1155/2020/6479140.

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Achilles tendon and malleolar fractures are commonly seen in isolation, but only a few cases of combined injuries have been reported. In this case, we present a 53-year-old male who sustained an isolated lateral malleolus fracture with an Achilles tendon rupture. Emergency Medicine physicians should consider the possibility of these injuries in combination.
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Carter, Tom H., Calum HC Arthur, Andrew D. Duckworth, and Timothy O. White. "To fix or not to fix: a novel approach to the safe management of unstable open medial malleolar fractures." BMJ Case Reports 12, no. 4 (2019): e228965. http://dx.doi.org/10.1136/bcr-2018-228965.

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Displaced medial malleolar fractures, either in isolation or as part of an unstable ankle fracture dislocation, are conventionally treated with internal fixation. We outline the case of a 76-year-old man with diabetes presenting with a grossly deformed open ankle fracture and extruded tibia through a large medial wound. Following irrigation, wound debridement and minimally invasive fibular fixation, the medial fracture reduced anatomically. Contrary to traditional teaching, the medial malleolus was left without fixation. The patient mobilised partially weight-bearing, progressing to both clini
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Hovis, W. David, and Robert W. Bucholz. "Polyglycolide Bioabsorbable Screws in the Treatment of Ankle Fractures." Foot & Ankle International 18, no. 3 (1997): 128–31. http://dx.doi.org/10.1177/107110079701800303.

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Twenty-one patients with unstable medial malleolar, bimalleolar, or trimalleolar ankle fractures underwent open reduction and internal fixation of the medial malleolus with 4.5-mm polyglycolide screws. All lateral malleolar fractures were internally fixed with standard metallic implants. Radiographic and clinical follow-up results were available on 16 of 21 patients. All fractures healed at an average of 3.4 months (range, 3–6 months), and there were no medial wound infections. Eight of 16 patients developed an inflammatory reaction to the biodegradable polyester at 3 to 4 months after implant
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Alamgir, MHM, Monowarul Islam, Md Nazrul Islam, and Abdul Kader. "Open Reduction and Internal Fixation of Displaced Fractures of Lateral Malleolus by Tension and Wiring and Plating in Bimalleolar Fractures in Adults." Journal of Shaheed Suhrawardy Medical College 5, no. 2 (2013): 81–83. http://dx.doi.org/10.3329/jssmc.v5i2.20760.

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Background: Lateral malleolus is the key structure for anatomic reduction of the displaced bi-malleolar fracture and that restored the integrity of stability of ankle. Therefore, accurate reduction and fixation is needed for proper functioning of the joint.Objectives: The purpose of the present study was to find out the better method of fixation for the unstable lateral malleolar fracture between tension band wiring and semitubular plating.Methodology: This was a prospective study carried out the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) Dhaka during the period
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Bhargavevem, Krishna, Anvesh Kumar Kondlapudi, Sai Pavan Kumar Murari, and Srinivasa Murthy. "OUTCOME OF SURGICAL MANAGEMENT OF BIMALLEOLAR FRACTURES IN ADULTS." Asian Journal of Pharmaceutical and Clinical Research 10, no. 11 (2017): 252. http://dx.doi.org/10.22159/ajpcr.2017.v10i11.20808.

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Objectives: Appropriate management of malleolar injuries is crucial as the ankle is an important weight-bearing joint, and locomotion is determined by and dependent on joint stability. We studied the functional outcome of surgically managed bimalleolar fractures of the ankle.Methods: Fractures were classified anatomically and as per Lauge–Hansen, arbeitsgemeinschaft für osteosynthesefragen (AO)/orthopedic trauma association classification. The stability of the structures at the fracture site, the extent of damage, mechanism of injury was assessed. Radiologically, tibiofibular clear space of &g
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Williamson, Emilie, Kevin Rosas, John Dankert, et al. "Incidence of Chondral and Osteochondral Lesions in Ankle Fracture Patients Identified with Ankle Arthroscopy Following Rotational Ankle Fracture." Foot & Ankle Orthopaedics 5, no. 4 (2020): 2473011420S0049. http://dx.doi.org/10.1177/2473011420s00494.

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Category: Ankle; Trauma Introduction/Purpose: It is controversial whether routine arthroscopy is beneficial at the time of ankle fracture fixation. This may be, in part, due to sparse information regarding the incidence of chondral injury in the setting of ankle fractures.The purpose of this study is to systematically review the incidence of chondral injures in patients with ankle fractures and to further characterize intra-articular chondral injuries of the talus, tibial plafond, medial malleolus, and lateral malleolus in patients who undergo ankle arthroscopy following an ankle fracture. Met
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Myers, Devon, Benjamin D. Umbel, Shane Forsting, Benjamin C. Taylor, and Sergio H. Pulido. "Impact of Early Weight Bearing on Outcomes after Open Reduction and Internal Fixation of Trimalleolar Ankle Fractures." Foot & Ankle Orthopaedics 5, no. 4 (2020): 2473011420S0036. http://dx.doi.org/10.1177/2473011420s00365.

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Category: Ankle; Trauma Introduction/Purpose: There is a current trend to allow earlier weight-bearing of unstable ankle fractures after fixation. This study offers a unique comparison of early (EWB) versus late weight-bearing (LWB) in operatively stabilized trimalleolar ankle fractures. The purpose of this study was to evaluate union rates, clinical outcomes and complications in patients managed with EWB versus LWB. Methods: We performed a retrospective review of 185 patients with trimalleolar ankle fractures who underwent surgical stabilization. Fixation of the posterior malleolus and weight
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Çağlar, Ceyhun, Serhat Akçaalan, and Mustafa Akkaya. "Anatomically Fixed Posterior Malleolar Fractures in Syndesmosis Injuries without Transsyndesmotic Screw Fixation." Foot & Ankle International 43, no. 4 (2021): 486–94. http://dx.doi.org/10.1177/10711007211060067.

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Background: The stability of the syndesmosis is extremely important in terms of syndesmosis injury, ankle instability, and posttraumatic osteoarthritis development following ankle fractures. The aim of this study is to evaluate 1-year radiographic outcomes after posterior malleolar fixation in lateral and posterior malleolar fractures and trimalleolar fractures without transsyndesmotic screw fixation. Methods: Ninety-four patients who underwent posterior malleolar fixation with posterolateral approach between January 2017 and June 2019 were evaluated retrospectively. The patients were evaluate
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Carter, T. H., W. M. Oliver, K. R. Bell, C. Graham, A. D. Duckworth, and T. O. White. "MEDIAL MALLEOLUS: OPERATIVE OR NONOPERATIVE (MOON): A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF OPERATIVE VERSUS NONOPERATIVE MANAGEMENT OF ASSOCIATED MEDIAL MALLEOLUS FRACTURES IN UNSTABLE ANKLE FRACTURES." Orthopaedic Proceedings 105-B, SUPP_6 (2023): 7. http://dx.doi.org/10.1302/1358-992x.2023.6.006.

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This prospective randomised trial aimed to assess the superiority of internal fixation of well-reduced medial malleolar fractures (displacement □2mm) compared with non-fixation, following fibular stabilisation in patients undergoing surgical management of a closed unstable ankle fracture.A total of 154 adult patients with a bi- or trimalleolar fracture were recruited from a single centre. Open injuries and vertically unstable medial malleolar fractures were excluded. Following fibular stabilisation, patients were randomised intra-operatively on a 1:1 basis to fixation or non-fixation after sat
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Myatt, Darren, Howard Stringer, James Chapman, Ben E. Fischer, and Lyndon Mason. "Morphology of occult posterior malleolus fractures associated with tibial shaft fractures." Bone & Joint Open 6, no. 4 (2025): 446–53. https://doi.org/10.1302/2633-1462.64.bjo-2024-0132.r1.

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AimsOccult posterior malleolar fractures (PMFs) associated with tibial shaft fractures are thought to occur most commonly in spiral fracture types of the tibia. We hypothesize that tibial diaphyseal fracture patterns would be associated with certain PMFs, highlighting the pathomechanics of the injury.MethodsA retrospective review was performed on data collected between 1 January 2013 and 9 November 2020. The inclusion criteria were patients aged over 16 years with a diaphyseal tibial fracture who had undergone a CT of the affected lower limb. The Mason and Molloy posterior malleolar fracture c
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De Souza Fernandes, Guilherme, and Claudio Velleca e Silva. "PO 18204 - Posterior ankle arthroscopy for percutaneous fixation of a posterior malleolar fracture." Scientific Journal of the Foot & Ankle 13, Supl 1 (2019): 44S. http://dx.doi.org/10.30795/scijfootankle.2019.v13.1032.

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Introduction: The authors report the case of a 47-year-old patient who fell and experienced a sprained ankle that progressed to posterolateral fracture-dislocation of the ankle and Lauge-Hansen stage 4 supination-external rotation. Objective: To evaluate the use of posterior ankle endoscopy to facilitate the internal fixation of a posterior malleolar fracture. Methods: Case report of a patient with posterolateral fracture-dislocation of the ankle and description of the use of endoscopy for treatment. Examinations performed in the emergency room showed evidence of posterior malleolar fracture w
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