Abstract
Objective: Ankle fracture is a common orthopedic injury1. Ankle laxity varies depending on the plantar flexion-dorsiflexion position and the direction of the applied force so light rotational forces can cause complex ankle fracture2. Careful evaluation of x rays and clinical examination are mandatory for succeful outcome.
Methods: We reviewed 15 cases of ankle fracture with posterior malleolar involvement. We operated all cases by posterolateral approach in semi lateral position.
Result: Semilateral position and posterolateral approach allows a great exposure of all malleoli. This makes interpretation of fracture and fixation easy.
Conclusion: we strongly recommend semilateral position and posterolateral approach for all fibula fracture with post. malleoli involvement.
Keywords: posterior malleoli, planter flexion, dorsiflexion, pasterolateral, semilateral.
References
- Foot Ankle Int. 2005 Aug;26(8):633-7., Arch Osteoporos. 2017 Aug 28;12(1):75. doi: 10.1007/s11657-017-0369-5., Lower limb fracture presentations at a regional hospital.. Holloway KL1, Yousif D2, Bucki-Smith G2, Hosking S2,3, Betson AG2, Williams LJ2, Brennan-Olsen SL2,3,4,5, Kotowicz MA2,5,6, Sepetavc A2, Pasco JA2,5,6.
- Analysis of ankle-hindfoot stability in multiple planes: an in vitro study. Fujii T1, Kitaoka HB, Luo ZP, Kura H, An KN.
- J Foot Ankle Surg. 2015 Mar-Apr;54(2): 203-6. doi: 10.1053/j.jfas.2014.10.015. Epub 2014 Dec 5., Are low-energy open ankle fractures in the elderly the new geriatric hip fracture?, Toole WP1, Elliott M2, Hankins D2, Rosenbaum C2, Harris A2, Perkins C2.
- J Orthop Trauma. 1992;6(1):96-101. Posterior malleolar ankle fractures: an in vitro biomechanical analysis of stability in the loaded and unloaded states., Scheidt KB1, Stiehl JB, Skrade DA, Barnhardt T.
- J Orthop Trauma. 2015 Apr;29(4):e151-6. doi: 10.1097/BOT.0000000000000230."A to p" screw versus posterolateral plate for posterior malleolus fixation in trimalleolar ankle fractures. OʼConnor TJ1, Mueller B, Ly TV, Jacobson AR, Nelson ER, Cole PA.
- 1999 Jun;28(6):460-8. [The upper ankle joint. Biomechanics and functional anatomy].[Article in German], Seiler H1.
- Bone Joint J. 2016 Jun;98-B(6):812-7. doi: 10.1302/0301-620X.98B6.36497. Open reduction and internal fixation of posterior malleolar fractures using the posterolateral approach. Verhage SM1, Boot F1, Schipper IB2, Hoogendoorn JM2.
- Eur J Trauma Emerg Surg. 2015 Dec;41(6):587-600. doi: 10.1007/s00068-015-0560-6. Epub 2015 Aug 8. Posterior malleolar fractures of the ankle. Bartoníček J1,2, Rammelt S3, Tuček M4, Naňka O5.
- Can J Surg. 2005 Dec;48(6):487-90. Posterolateral approach for open reduction and internal fixation of trimalleolar ankle fractures. Talbot M1, Steenblock TR, Cole PA.
- Foot Ankle Clin. 2017 Mar;22(1):125-145. doi: 10.1016/j.fcl.2016.09.009. Epub 2016 Dec 20. Posterior Malleolar Fractures: Changing Concepts and Recent Developments. Bartoníček J1, Rammelt S2, Tuček M3.
- J Bone Joint Surg Am. 1988 Oct;70(9):1348-56. Posterior malleolar fractures of the ankle associated with external rotation-abduction injuries. Results with and without internal fixation. Harper MC1, Hardin G.
- Foot Ankle Int. 2015 Apr;36(4):377-82. doi: 10.1177/1071100714558845. Epub 2014 Nov 3. Analysis of PITFL injuries in rotationally unstable ankle fractures. Warner SJ1, Garner MR2, Schottel PC2, Hinds RM2, Loftus ML3, Lorich DG4.
- Odak S, Ahluwalia R, Unnikrishnan P, Hennessy M, Platt S. Management of Posterior Malleolar Fractures: A Systematic Review. J Foot Ankle Surg. 2016;55(1):140–5. doi: 10.1053/j.jfas.2015.04.001.[PubMed]
- Donatto, 2001. Donatto KC: Ankle fractures and syndesmosis injuries. Orthop Clin North Am 2001; 32:79.
Corresponding Author
Dr Amit Lakhani
MMM College and Hospital
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.183
