J Foot Ankle Surg 50:607–611Īhn J, Kim S, Lee JS, Woo K, Sung KS (2016) Incidence of peroneal tendinopathy after application of a posterior antiglide plate for repair of supination external rotation lateral malleolar fractures. This chapter presents guidelines and tips for the surgical management of ankle malleolus fractures (lateral, medial, posterior), including clinical comparison of a variety of surgical fixation methods.Ībdelgawad AA, Kadous A, Kanlic E (2011) Posterolateral approach for the treatment of posterior malleolus fracture of the ankle. As the importance of minimally invasive fracture surgery has increased in order to minimize complications such as non-union and soft tissue injuries, the concordant evolution of the use of arthroscopy in “joint-related fracture” surgery has developed. In contrast to well-established management of lateral and medial malleolar fractures, the management of posterior malleolar fractures is still controversial. Although a nonsurgical approach is applicable in non-displaced fractures, surgical management has been favored for more than 40 years. Anatomical reduction and stable fixation of medial malleolar fractures are important in order to restore ankle mortise stability, to obtain healthy bony union and early ankle motion. Various surgical fixation methods have been described for the treatment of lateral malleolar fractures, but the best method is still to be determined. The two main lateral malleolar fracture fixation categories are plating and intramedullary fixation. Staged treatment with external fixation and delayed internal fixation is reserved for high-energy fractures/fracture dislocations with compromised surrounding soft tissues. In general, stable and unstable ankle fractures can be managed nonsurgically or surgically, respectively. Malleolar fracture management can be summarized into three general approaches: nonsurgical, staged, and surgical.
The most common ankle joint fracture patterns are lateral malleolar, bimalleolar, and trimalleolar fractures. A spectrum of injuries is possible from stable simple soft tissue injuries to unstable, complex open ankle fractures or fracture dislocations. The ankle joint is the most commonly injured weight-bearing joint in the human body.
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