Posterior Malleolar Fractures: Changing Concepts and Recent Developments.
Injuries to the posterior malleolus are of prognostic relevance in ankle fracture-dislocations. The three-dimensional outline of the fragments as reflected by computed tomography classification, involvement of the fibular notch, and the presence of intercalary fragments seem to be of greater therapeutic relevance than the size of the fragment and amount of the articular surface involved. Operative treatment aims at reconstruction of the posterior tibial plafond, the fibular notch, and the integrity of the posterior inferior tibiofibular syndesmosis. Direct open reduction and fixation of posterior malleolus fragments via posterior approaches is biomechanically more stable than indirect reduction and anteroposterior screw fixation.
Department of Orthopaedics, First Faculty of Medicine, Central Military Hospital Prague, Charles University, U Vojenské Nemocnice 1200, Prague 6 169 02, Czech Republic; Department of Anatomy, First Faculty of Medicine, Charles University Prague, U Nemocnice 3, Prague 2 120 00, Czech Republic. Electronic address: bartonicek.jan@seznam.cz.
Jan
J
Bartoníček
University Center of Orthopaedics and Traumatology, University Hospital Carl Gustav Carus Dresden, Fetscherstrasse 74, Dresden 01307, Germany.
Stefan
S
Rammelt
Department of Orthopaedics, First Faculty of Medicine, Central Military Hospital Prague, Charles University, U Vojenské Nemocnice 1200, Prague 6 169 02, Czech Republic.
Michal
M
Tuček
D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D000072039:Fracture Dislocation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005592:Fracture Fixation; D006801:Humans; D014057:Tomography, X-Ray Computed
Ankle fractures; Classification; Posterior approaches; Posterior malleolus; Trimalleolar fractures