Posterior malleolus fractures and their role in prognosis of malleolar fractures

Abstract

Introduction: The treatment of ankle fractures with involvement of the posterior tibial margin remains a subject of debate. We have evaluated the clinical, radiological, and functional outcome of such fractures in 25 patients, all of which were managed surgically over an average follow- up period of 6 months. The treatment options available for malleolar fractures, to attain a proper anatomical alignment and stability of ankle joint, can lead to rewarding outcome for the patient. Materials and Methods : 25 patients with posterior malleolus fractures were managed surgically between June 2019 to November2021 were included in this series. The mean age, gender ratio, mode of trauma, fracture union time, and complications were noted. The AOFAS Hindfoot scores were used for assessing the Ankle function. Results : Of the 25 patients in the study, 21 were males and 4 were females. The mean age was 38.12 years. The mean fracture union (radiological) time was 14.04 weeks (range: 10–18 weeks). However Ankle function was excellent in 17 cases (68%) on the AOFAS hindfoot score with a average AOFAS score of 94.8. Also platting gives a better result than using cannulated cancellous screws. Better syndesmotic stability is observed after surgically treating posterior malleolus fractures. Conclusion : Fixation of the posterior malleolus to reduce persistent fragment displacement, regardless of size, as well as to restore syndesmotic stability, may lead to improved outcomes. We conclude that posterior malleolar fractures encountered in clinical practice need thorough assessment and meticulous surgical intervention. We achieved stable fixation and performed early mobilization of the ankle joint, which limits the complications of mainly ankle stiffness and have achieved excellent clinical and functional outcomes of surgically fixing the posterior malleolus fractures.