Malleolar fractures of the ankle. A comprehensive review

Ankle injuries and associated malleolar fractures are common. The outcome of treatment depends on the treating physician's ability to properly identify the mechanism of injury and subsequently restore ankle function by accurate realignment of the normal ankle articulations. Particular attention must be paid to restoring the length and alignment of the fibula because it plays a major role in stabilizing the talar ankle component. The medial aspect of the ankle also is important. The vital role of the deltoid has been proved in many studies, and although controversy exists in the proper treatment of this complex, there is agreement regarding the importance of at least identification of medial injury. Malleolar fractures of the ankle have varied presentations. They can range from an isolated fibular fracture with no displacement to a trimalleolar injury with dislocation and vascular compromise. A broad understanding of all aspects of pathoanatomy and treatment options, coupled with training experience, is required before any attempt should be made to treat these injuries. With a thorough understanding of injury patterns and proper fixation techniques, repair of the damaged ankle joint can lead to rewarding outcomes for the patient and physician.