Posterior malleolus fracture.

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Abstract

[Indexed for MEDLINE] 3. Rev Esp Cir Ortop Traumatol. 2023 Mar-Apr;67(2):T160-T169. doi: 10.1016/j.recot.2022.12.017. Epub 2022 Dec 24. [Translated article] Posterior malleolar fractures: Indications and surgical approaches. [Article in English, Spanish] Fernández-Rojas E(1), Herrera-Pérez M(2), Vilá-Rico J(3). Author information: (1)Equipo de Tobillo y Pie, Servicio de Traumatología y Ortopedia, Hospital Las Higueras, Talcahuano, Chile; Universidad Católica de la Santísima Concepción, Concepción, Chile. Electronic address: eefernandezrojas@gmail.com. (2)Unidad de Pie y Tobillo, Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Islas Canarias, Spain; Escuela de Medicina, Universidad de La Laguna, Santa Cruz de Tenerife, Islas Canarias, Spain. (3)Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, Spain; Departamento de Cirugía, Universidad Complutense de Madrid, Madrid, Spain. Posterior malleolus fractures are frequent injuries, present in 7-44% of all ankle fractures. The objective of this study is to review the evidence to indicate the fixation of this fracture and to choose the appropriate surgical approach. The classic indications for fixation were fragment size greater than 25-30% of the articular surface and displacement greater than 2mm. However, current evidence suggests that, rather than size, factors such as syndesmotic instability, intra-articular step-off greater than 1-2mm, plafond impaction and the presence of intercalary fragments should be considered. When comparing the different surgical approaches, the literature supports the use of posterior approaches and reserves the recommendation of the traditional approach for exceptional cases. For the treatment of this injury it is essential to know the anatomy of the ankle and to consider all the factors described above, in addition to the presence of concomitant injuries. Copyright © 2022 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved. DOI: 10.1016/j.recot.2022.12.017