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Journal articles on the topic 'Posterior Malleolus'

Author: Grafiati

Published: 3 June 2025

Last updated: 31 July 2025

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1

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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2

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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3

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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Deependra, Sonkar, Bansal Akhil, Chourasiya Shubham, Meher Brajesh, and Tandon Suneet. "Comparative Study of Fixation versus Conservative Treatment of Posterior Malleolar Fragment in Ankle Fractures." International Journal of Pharmaceutical and Clinical Research 14, no. 5 (2022): 124–31. https://doi.org/10.5281/zenodo.13824817.

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<strong>Background: </strong>Ankle fracture involving posterior malleolus, whether to fix it or not has always been a subject of controversy for a long time. Aim of this study was to compare the outcomes of fixation vs conservative treatment of trimalleolar ankle fractures. <strong>Material and Method:</strong> A total of 30 patient with ankle fracture were taken into study. In group I Posterior malleolus fracture was fixed by means of screw or plate in 18 patients  along with medial and lateral malleolus while in group II posterior malleolus fracture was left unfixed in 12

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5

El Ghazawy, Ahmed K., Mohamed Ismail Kotb, and Ahmed Saeed Younis. "Posterior versus lateral plating of lateral malleolus fractures using a posterolateral approach." Egyptian Orthopaedic Journal 58, no. 2 (2023): 133–38. http://dx.doi.org/10.4103/eoj.eoj_49_23.

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Abstract Aim We compared the clinical outcomes of fixing lateral malleolus fractures with lateral or posterior plating in combined lateral and posterior malleolar ankle fractures. Methods We randomized thirty patients with ankle fractures involving the posterior and lateral malleoli into two groups. In group 1, we dissected laterally, raising a lateral skin and subcutaneous flap to allow lateral fixation of the lateral malleolus. In group 2, we did not raise the flap fixing the lateral malleolus posteriorly by deep dissection and retracting the peroneal tendons laterally. During the follow-up

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LeMass, Harry, Nicholas Whitworth, and Simon Platt. "Defining A Safe Zone For Percutaneous Screw Fixation Of The Posterior Malleolus." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0031. http://dx.doi.org/10.1177/2473011418s00319.

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Category: Trauma Introduction/Purpose: Fixation of the posterior malleolar fragment of an ankle fracture confers stability. Not all posterior fragments are displaced, necessitating open reduction. We hypothesised that a safe anatomic corridor is possible for percutaneous screw fixation in some fracture variants. We conducted an anatomic study to determine if percutaneous fixation was possible and safe. This anatomic assessment of significant structures at the posterior ankle, combined with cadaveric dissection following placement of screw tracts shows that percutaneously fixing the posterior m

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7

Harper, Marion C. "Posterior Instability of the Talus: An Anatomic Evaluation." Foot & Ankle 10, no. 1 (1989): 36–39. http://dx.doi.org/10.1177/107110078901000107.

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A cadaver study was conducted to evaluate the role of the posterior tibial margin or posterior malleolus, as well as medial and lateral supporting structures, in providing posterior stability for the talus. Posterior malleolar fractures consisting of approximately 30%, 40%, and 50% of the articular margin on the lateral radiograph were created in specimens that were then subjected to posterior stressing. No posterior talar subluxation was noted in any specimen. Repeat stressing following removal of the medial malleolus again revealed no subluxation in any specimen. The lateral supporting struc

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8

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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9

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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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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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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Jackson, J. Benjamin, Christopher H. Chu, Kevin A. Williams, and Paul H. Bornemann. "Normal Ultrasonographic Parameters of the Posterior Tibial, Peroneal, and Achilles Tendons." Foot & Ankle Specialist 12, no. 5 (2018): 480–85. http://dx.doi.org/10.1177/1938640018800785.

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Tendinopathy of the foot and ankle is common and can lead to pain or functional limitations. The most frequently affected tendons in the foot and ankle are the posterior tibial, peroneal, and Achilles. We used ultrasound to determine normal values for these tendons. From 2015 to 2016, a prospective, standardized bilateral lower extremity ultrasound examination protocol was performed by a musculoskeletal ultrasonographer of the 4 tendons and above and below the malleoli as appropriate. A total of 199 patients with 398 extremities were identified, consented, and participated in the study. Most t

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13

Lovisetti, Giovanni, and Todd A. Irwin. "Posterior Malleolus Fracture." Journal of the American Academy of Orthopaedic Surgeons 22, no. 2 (2014): 67. http://dx.doi.org/10.5435/00124635-201402000-00001.

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14

Irwin, T. A., J. Lien, and A. R. Kadakia. "Posterior Malleolus Fracture." Journal of the American Academy of Orthopaedic Surgeons 21, no. 1 (2012): 32–40. http://dx.doi.org/10.5435/jaaos-21-01-32.

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15

Lovisetti, G., and T. A. Irwin. "Posterior Malleolus Fracture." Journal of the American Academy of Orthopaedic Surgeons 22, no. 2 (2014): 67. http://dx.doi.org/10.5435/jaaos-22-02-67.

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16

Meulenkamp, Brad, Hakim Louati, John Morellato, Steve Papp, and Karl Andre Lalonde. "Posterior malleolus exposure." OTA International 2, no. 2 (2019): e021. http://dx.doi.org/10.1097/oi9.0000000000000021.

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17

Streubel, Philipp N., Jeremy J. McCormick, and Michael J. Gardner. "The posterior malleolus." Current Orthopaedic Practice 22, no. 1 (2011): 17–24. http://dx.doi.org/10.1097/bco.0b013e318205a7c1.

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18

Tenenbaum, Shay, Nachshon Shazar, Nathan Bruck, and Jason Bariteau. "Posterior Malleolus Fractures." Orthopedic Clinics of North America 48, no. 1 (2017): 81–89. http://dx.doi.org/10.1016/j.ocl.2016.08.004.

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Solan, M. C., and A. Sakellariou. "Posterior malleolus fractures." Bone & Joint Journal 99-B, no. 11 (2017): 1413–19. http://dx.doi.org/10.1302/0301-620x.99b11.bjj-2017-1072.

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20

Tanpure, Sanket, Chandrasen Chaughule, Jay Date, Akash Sonawane, and Mayur Lohiya. "How we do it? Trimalleolar Fractures: Posterolateral Approach for Fixing the Syndesmotic Ligament, Posterior Malleolus, and Fibula." Journal of Orthopaedic Case Reports 13, no. 12 (2023): 153–58. http://dx.doi.org/10.13107/jocr.2023.v13.i12.4116.

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Introduction: Syndesmotic injury in trimalleolar fracture is necessary to address intraoperatively by stability test, as it affects post-operative functional outcomes. Most of syndesmotic injuries are stable after fixation of the posterior malleolus, but in rare cases, syndesmosis is not stable after adequate fixation. In those rare conditions, we have to fix syndesmosis by corticocancellous (CC) screw throw lateral fibula plate. We emphasize this complex problem and offer solutions to overcome it. Case Report: Case 1: A 45-year-old male suffered significant trauma to his right ankle from a sl

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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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Varma, Rohit, S. K. Rai, S. S. Wani, and Amit Chaudhary. "Evaluation of the role of posterior malleolus fixation in trimalleolar ankle fractures: a prospective study." International Journal of Research in Orthopaedics 3, no. 3 (2017): 512. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20171900.

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<p class="abstract"><strong>Background:</strong> Trimalleolar ankle fractures are relatively rare and complex ankle injuries, the prognosis of which is worse than bimalleolar fracture. The three malleoli are bony restraints of the ankle and all three are fractured in trimalleolar fractures. Hence, there is disruption of the weight bearing portion of the tibial plafond along with talus dislocation/subluxation. Management of such fractures is challenging and confounded by the dilemma of posterior malleolus fixation. Aim: The aim of the present study was to evaluate the radiolog

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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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Solasz, Sara, Abhishek Ganta, and Sanjit R. Konda. "Posteromedial Surgical Approach for Fixation of Haraguchi Type 2B Posterior Malleolar Fracture." Journal of Orthopaedic Trauma 37, no. 8S (2023): S9—S10. http://dx.doi.org/10.1097/bot.0000000000002634.

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Summary: A case of a 26-year-old man with a displaced medial malleolus fracture with extension into the posteromedial aspect of the posterior malleolus is presented. A CT scan of the ankle is obtained demonstrating a Haraguchi type 2B posterior malleolus fracture with a posteromedial and posterolateral fragment. The posteromedial fragment extends into the posterior colliculus of the medial malleolus and has a subchondral impaction fracture. There is also a 1 × 1 cm piece of the articular surface of the posterior malleolus that has flipped 90 degrees and lodged itself between the posterolateral

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Li, Xian, Xiao-ke Wang, Li-ren Han, et al. "Evaluation of the horizontal approach to the medial malleolar facet in sagittal talar fractures through dorsiflexion and plantarflexion positions." PLOS ONE 19, no. 5 (2024): e0295350. http://dx.doi.org/10.1371/journal.pone.0295350.

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Background Talar fractures often require osteotomy during surgery to achieve reduction and screw fixation of the fractured fragments due to limited visualization and operating space of the talar articular surface. The objective of this study was to evaluate the horizontal approach to the medial malleolus facet by maximizing exposure through dorsiflexion and plantarflexion positions. Methods In dorsiflexion, plantarflexion, and functional foot positions, we respectively obtained the anterior and posterior edge lines of the projection of the medial malleolus on the medial malleolar facet. The ta

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Martin, Kevin D. "Posterior Arthroscopic Reduction and Internal Fixation for Treatment of Posterior Malleolus Fractures." Foot & Ankle International 41, no. 1 (2019): 115–20. http://dx.doi.org/10.1177/1071100719891978.

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Posterior malleolus fractures and pilon variants refer to a pattern of fractures involving the posterior weightbearing surface of the tibial plafond. The surgical indications for fixation of posterior malleolus fractures varies considerably throughout the literature, based on the size and/or displacement. There is controversy on how to best address fracture fixation, with the main workhorses being either the posterior-lateral approach or indirect anterior-posterior–directed screws. We present an alternative technique for posterior malleolus fracture fixation using a direct posterior arthroscop

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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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Jindal, Rajneesh. "Assessment of incidence of occurrence of fractures of posteriors malleolus region: a retrospective analysis." International Journal of Research in Medical Sciences 5, no. 5 (2017): 2233. http://dx.doi.org/10.18203/2320-6012.ijrms20171875.

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Background: Fracture of ankle joint involving posterior malleolus easily causes traumatic arthritis and prognosis of this fracture is poor. There are a number of controversies regarding the indications for fixation of fragments of posterior malleolus. Some studies report that if the articular surface at the distal end of the tibia accounts for more than twenty five percent, then fixation of posterior malleolus fragments should be done. In this retrospective study we evaluated the treatment effect of ankle joint fractures involving the posterior malleolus and analyzed the impact of different po

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Bansal, Tungish, Mandeep S. Dhillon,, and Kamal Dureja,. "How We do It. Trimalleolar Fractures: Fixing the Posterior Malleolus by Posterolateral Approach." Journal of Foot and Ankle Surgery (Asia Pacific) 4, no. 2 (2017): 63–68. http://dx.doi.org/10.5005/jp-journals-10040-1073.

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ABSTRACT The understanding of trimalleolar fractures and, in particular, the posterior malleolus fragment has drastically evolved over the last decade. There has been a tilt in favor of fixing almost all posterior malleolus fragment in contrast to the old school thought of the 20th century. The concept of stability offered by posterior malleolus fixation to the syndesmotic stability is well understood now. Posterolateral approach has almost evolved as a gold standard approach for posterior malleolus fixation. How to cite this article Dhillon MS, Dureja K, Patel S, Bansal T. How We do It. Trima

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Lu, Jike. "Differences between Posterior Malleolus and Posterior Pilon Fractures-A Review." Journal of Clinical Research and Reports 18, no. 2 (2025): 01–08. https://doi.org/10.31579/2690-1919/477.

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Based on our last 7 years (2015-2022) 98 consecutive trimalleolar ankle fracture data base, we did a review of literature review trying to elucidate the differences between posterior malleolus fractures and posterior Pilon fractures. Posterior malleolus fractures are commonly caused by rotational forces on the ankle joint with foot in different positions, leading to different injuries from tearing of the posterior inferior tibiofibular ligament (PITFL) to an avulsion fracture of the posterior malleolus (PM). This is generally a low-energy injury and actually does not involve the joint articula

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White, T. O. "In defence of the posterior malleolus." Bone & Joint Journal 100-B, no. 5 (2018): 566–69. http://dx.doi.org/10.1302/0301-620x.100b5.bjj-2017-1440.r1.

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The posterior malleolus of the ankle is the object of increasing attention, with considerable enthusiasm for CT scanning and surgical fixation, as expressed in a recent annotation in The Bone & Joint Journal. Undoubtedly, fractures with a large posterior malleolar fragment that allow posterior talar subluxation from the mortise are served better by fixation. However, in all other situations, the existing literature does not support this widespread change in practice. The available biomechanical evidence shows that the posterior malleolus has little part to play in the stability or contact

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Wang, Jinwu, Xingyu Wang, Linzhen Xie, Wenhao Zheng, Hua Chen, and Leyi Cai. "Comparison of radiographs and CT features between posterior Pilon fracture and posterior malleolus fracture: a retrospective cohort study." British Journal of Radiology 93, no. 1110 (2020): 20191030. http://dx.doi.org/10.1259/bjr.20191030.

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Objectives: This study explored the morphological differences between posterior Pilon fracture and posterior malleolus fracture from radiographs and CT to provide detail for diagnosis and treatment of them. Methods: Radiographs and CT imaging data of 174 patients with distal posterior tibial fractures who were treated from January 2013 to January 2019 were retrospectively analyzed. Based on the operation and imaging examination, the fractures were classified into posterior Pilon fractures and posterior malleolus fractures. Radiographic parameters including the width, height, depth, α angle, β

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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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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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Chen, Qun, Lijun Song, Jiahu Fang, Xiaodong Qin, Tianrun Lv, and Xiang Li. "Effectiveness of Diagnosis and Treatment of Spiral Fracture of the Distal Third of the Tibia Combined with Posterior Malleolus Fracture." Journal of the American Podiatric Medical Association 108, no. 2 (2018): 106–14. http://dx.doi.org/10.7547/15-181.

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Background: Spiral fractures of the tibia are often the result of torsion trauma. In clinical practice, this type of fracture is frequently complicated by posterior malleolus fractures. This study aimed to observe the effectiveness of diagnosis and treatment of these fractures in a single hospital in China. Posterior malleolus fractures are sometimes occult, occurring alongside spiral fractures of the distal third of the tibia; posttraumatic arthritis can result if they are missed. Methods: This study includes 128 consecutive patients with tibia fractures between May 1, 2008, and April 30, 201

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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: </strong>Ankle fractures are one of the most common lower limb injuries, accounting for about 9 % of all fractures.  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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Ma, Xin. "Anatomic Study of Exposed Posterior Malleolus Using the Posterolateral Ankle Approach." Journal of Orthopaedics & Bone Disorders 5, no. 1 (2021): 1–5. http://dx.doi.org/10.23880/jobd-16000203.

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We compared the effect of the posterolateral ankle approach on the exposed posterior malleolus and vascular nerves in order to reduce the probability of vascular nerve injury during surgical exposure. Five corpses were randomly allocated to incision A and B groups. The tip of the lateral malleolus was used as a starting point, while the lateral line of the Achilles tendon was used as the endpoint to its trisection. Using the two points near the side of the Achilles tendon, we drew two vertical horizontal lines to represent incisions A and B, then measured the horizontal distances between the t

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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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Kalekar, Rahul, Vikrant R. Kalamb, Aakash Gaurav, Rahul Damle, Nilesh Kamat, and M. A. Naser. "The clinical outcome of fixation of posterior malleolus fragment in trimalleolar ankle fracture." International Journal of Research in Orthopaedics 11, no. 4 (2025): 716–22. https://doi.org/10.18203/issn.2455-4510.intjresorthop20251789.

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Background: Trimalleolar ankle fractures are complex injuries that often require surgery. Posterior malleolus fixation is important to restore ankle stability and function. The aim of this study was to evaluate the clinical outcomes associated with posterior malleolus fixation in patients with ankle fractures in the malleolus ankle fracture. Methods: From 2018 to 2024, clinical outcomes were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) score, range of motion measurements, and radiographic evaluations. Complications and functional recovery were carefully recorded to ana

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Weber, Martin, and Reinhold Ganz. "Malunion following Trimalleolar Fracture with Posterolateral Subluxation of the Talus — Reconstruction Including the Posterior Malleolus." Foot & Ankle International 24, no. 4 (2003): 338–44. http://dx.doi.org/10.1177/107110070302400406.

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Malunion after a malleolar fracture can include a displaced posterior malleolus with associated posterolateral subluxation of the talus. Corrective osteotomy including the posterior malleolus was performed in four patients. Joint congruity was obtained in every case. The patients were followed for 46 to 80 months postoperatively. They all experienced an improvement in pain and three of four patients were unlimited in their walking capacity. Mild to moderate residual symptoms were frequent. The symptoms were attributed to the damage of the cartilage and soft-tissues both from the initial injury

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Zha, Junpu, Guolei Zhang, Jingtao Zhang, Xiaoqing Wang, Jie Li, and Jun Di. "Analysis of the Effect of Posterior Lateral Malleolus Plate Fixation on the Curative Effect and Mechanical Stability of Complex Ankle Fractures." Contrast Media & Molecular Imaging 2022 (June 6, 2022): 1–6. http://dx.doi.org/10.1155/2022/7101007.

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This paper investigates the effect of lateral and posterior 1/3 tubular plate bone plate fixation on the curative effect, wound healing, and mechanical stability of complex ankle fracture. 80 patients with complex ankle fractures treated in our hospital from January 2018 to July 2020 are selected for the study, and 80 patients are randomly divided into posterior fixation group and lateral fixation group according to the number table method, with 40 patients in each group. Patients in the posterior malleolus fixation group are treated with posterior lateral malleolus plate fixation, and patient

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Zha, Junpu, Guolei Zhang, Jingtao Zhang, Xiaoqing Wang, Jie Li, and Jun Di. "Analysis of the Effect of Posterior Lateral Malleolus Plate Fixation on the Curative Effect and Mechanical Stability of Complex Ankle Fractures." Contrast Media & Molecular Imaging 2022 (June 6, 2022): 1–6. http://dx.doi.org/10.1155/2022/7101007.

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This paper investigates the effect of lateral and posterior 1/3 tubular plate bone plate fixation on the curative effect, wound healing, and mechanical stability of complex ankle fracture. 80 patients with complex ankle fractures treated in our hospital from January 2018 to July 2020 are selected for the study, and 80 patients are randomly divided into posterior fixation group and lateral fixation group according to the number table method, with 40 patients in each group. Patients in the posterior malleolus fixation group are treated with posterior lateral malleolus plate fixation, and patient

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Janik, Krzysztof, and Dariusz Grzelecki. "Minimally invasive fixation of posterior malleolus fracture: description of surgical technique and radiological results." Chirurgia Narządów Ruchu i Ortopedia Polska 89, no. 2 (2024): 72–78. http://dx.doi.org/10.31139/chnriop.2024.89.2.4.

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Introduction. Ankle fractures are one of the most common lower extremity injuries. Despite the high incidence of these fractures in the population, the best therapeutic approach has not been established yet. The treatment of posterior malleolus fractures is particularly controversial. Aim. Evaluation of percutaneous posterior-to-anterior fixation of posterior malleolus fracture (posterolateral fragment) in terms of safety of the method and accuracy of fracture reduction. A detailed description of the surgical technique was also presented. Materials and methods. A retrospective evaluation inclu

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Vosoughi, Amir Reza, Hamid Ravanbod, Mark Gilheany, Mohammad Ali Erfani, and Kamran Mozaffarian. "Posterior tibialis tendon rupture associated with closed medial malleolus fracture and avulsion of anterior talofibular ligament: A case report and review of the literature." Hong Kong Journal of Emergency Medicine 25, no. 4 (2018): 232–35. http://dx.doi.org/10.1177/1024907917753441.

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Introduction: Traumatic rupture of posterior tibialis tendon in association with medial malleolus fracture is extremely rare. Case Presentation: We demonstrate our experience in the management of a complete posterior tibialis tendon (PTT) rupture and anterior talofibular ligament avulsion fracture from the talus in association with medial malleolus fracture in a 30-year-old male motorcyclist without any open wounds. Discussion: We believe this to be the first reported injury of this type in the literature. Closed ankle fractures may obscure surrounding tendon rupture and the clinician may be t

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FU, Su, Zhen-yu ZOU, Gang MEI, and Dan JIN. "Advances and disputes of posterior malleolus fracture." Chinese Medical Journal 126, no. 20 (2013): 3972–77. http://dx.doi.org/10.3760/cma.j.issn.0366-6999.20131514.

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Objective The objective of this article is to summarize the development of evaluation and treatment of posterior malleolus fracture (PMF). Data sources Data used in this review were mainly from English literature of PubMed data base. Study selection Articles were included in this review if they were related to the PMF or trimalleolar fracture. Results No consensus was found regarding what sizes of posterior malleolus fragments would lead to ankle instability thus affecting prognosis and should be fixed. X-ray measurement is unreliable, while CT scan is widely recommended and it can recognize t

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Miller, Anna N., Eben A. Carroll, Robert J. Parker, Sreevathsa Boraiah, David L. Helfet, and Dean G. Lorich. "Direct Visualization for Syndesmotic Stabilization of Ankle Fractures." Foot & Ankle International 30, no. 5 (2009): 419–26. http://dx.doi.org/10.3113/fai-2009-0419.

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Background: Ankle fractures with syndesmotic injury treated via standard trans-syndesmotic fixation have a high percentage of syndesmotic malreduction. 10 We established a protocol involving both direct syndesmosis visualization and meticulous tibial incisura reconstruction via the posterior malleolus fracture fragment, when present, via the attached, intact PITFL, then compared this with historic controls to assess improvement after this type of syndesmosis reconstruction. Materials and Methods: One hundred forty-nine consecutive direct visualization patients were treated prospectively with e

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Prasarn, Mark L., and Dean G. Lorich. "Posterior Malleolus Fractures in Athletes." Operative Techniques in Sports Medicine 25, no. 2 (2017): 82–86. http://dx.doi.org/10.1053/j.otsm.2017.03.007.

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Park, Yoo Jung, and Yougun Won. "The outcome of a single percutaneous cannulated screw fixation in posterior malleolus fracture accompanied by medial or lateral malleolus fracture." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0037. http://dx.doi.org/10.1177/2473011418s00379.

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Category: Trauma Introduction/Purpose: Posterior malleolus fractures occur most commonly in the setting of a rotational ankle fracture. In the treatment of posterior malleolus fractures, the indications for the surgical procedure are determined by the size of the fragment and the articular congruity of the tibiotalar joint. In general, the size of the bone fragment is known to be an indication of surgery if it involves more than 25% of the joint surface, and if it is less than that, anatomical reduction and fixation of only lateral or medial malleolus was suggested. We evaluate the clinical an

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Tavares, Camilo Miranda de Pinho, Rodrigo Simões Castilho, Fernando Araújo Silva Lopes, Daniel Soares Baumfeld, Thiago Alexandre Alves Silva, and Roberto Zambelli de Almeida Pinto. "Incidence of early complications in the posterolateral approach to posterior malleolus fractures." Journal of the Foot & Ankle 14, no. 2 (2020): 178–82. http://dx.doi.org/10.30795/jfootankle.2020.v14.1185.

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Introduction: To ascertain the incidence of early complications in the posterolateral approach to open reduction and internal fixation of posterior malleolar fractures and identify possible risk factors related to occurrence of these complications. Methods: Retrospective study carried out in three tertiary hospitals. Patients who underwent open reduction and internal fixation of posterior malleolus fractures via the posterolateral route were divided into two groups: with versus without delayed postoperative healing. To assess risk and protective factors for the outcome of delayed healing, we e

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McDonald, Elizabeth, Brian Winters, Rachel Shakked, David Pedowitz, Steven Raikin, and Joseph Daniel. "Effect of Post-Operative Toradol Administration on Bone Healing After Ankle Fracture Fixation." Foot & Ankle Orthopaedics 2, no. 3 (2017): 2473011417S0002. http://dx.doi.org/10.1177/2473011417s000288.

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Category: Ankle, Trauma Introduction/Purpose: Ketorolac has been reported to delay bone healing when administered after spine surgery, and there is hesitancy to use non-steroidal anti-inflammatories (NSAIDs) in the fracture setting despite its reliable ability to relieve surgical pain. The effect of ketorolac administration after foot and ankle surgery has not been well-defined in the literature to date. The purpose of this study is to report clinical and radiographic outcomes for patients treated with a perioperative ketorolac regimen after open reduction and internal fixation (ORIF) of ankle

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