title: A retrospective study of posterior malleolus fractures.
abstract: OBJECTIVE
  In this retrospective study, we evaluated the treatment effect of ankle joint fracture surgery involving the posterior malleolus, and discuss relevant factors influencing the occurrence of traumatic arthritis of the ankle joint.
  
  
  METHODS
  A total of 102 cases of ankle joint fractures involving the posterior malleolus in five large-scale skeletal trauma centres in China, from January 2000 to July 2009, were retrospectively analysed in terms of surgical treatment and complete follow-up. Ankle joint mobility, posterior malleolus fragment size, articular surface evenness, Ankle-Hindfoot Scale of the American Orthopedic Foot and Ankle Society (AOFAS) score, and imaging scale score for arthritis were recorded. The degree of fracture pain during rest, active movement, and weight-bearing walking, and satisfaction with treatment were evaluated using a visual analogue scale (VAS).
  
  
  RESULTS
  The average AOFAS score was 95.9, excellence rate was 92.2 %, and average VAS scores for degree of fracture pain during rest, active movement, and weight-bearing walking were 0.15, 0.31, and 0.68, respectively. Thirty-six cases showed arthritic manifestations. Ankle joint mobility along all directions on the injured side was lower than that on the unaffected side. There was no obvious difference in treatment effect between the fixed and unfixed posterior malleolus fragment groups for all and for fragment size of < 25 %; between fixing the posterior malleolus fragment from front to back or from back to front; or between elderly patients (≥ 60 years old) and young patients (< 60 years old). There was a distinct difference in the treatment effect between articular surface evenness and unevenness for all and for fragment size of ≥ 25 %.
  
  
  CONCLUSIONS
  For all 102 cases of ankle joint fracture involving the posterior malleolus, the treatment effect was satisfactory. Restoration of an even articular surface, especially when fragment size ≥ 25 %, should be attempted during treatment.
authors: Department of Orthopaedic Trauma, Peking University People's Hospital, Beijing 100044, China.
authors: Hai-lin
authors: HL
authors: Xu
authors: Xuan
authors: X
authors: Li
authors: Dian-ying
authors: DY
authors: Zhang
authors: Zhong-guo
authors: ZG
authors: Fu
authors: Tian-bing
authors: TB
authors: Wang
authors: Pei-xun
authors: PX
authors: Zhang
authors: Bao-guo
authors: BG
authors: Jiang
authors: Hui-liang
authors: HL
authors: Shen
authors: Gang
authors: G
authors: Wang
authors: Guang-lin
authors: GL
authors: Wang
authors: Xin-bao
authors: XB
authors: Wu
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001168:Arthritis / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D050723:Fractures, Bone / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000473:pathology; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D016138:Walking; D016474:Weight-Bearing; D055815:Young Adult