Principles of operative treatment of malleolar fractures today

Ankle fractures continue to be a common injury. They involve various mechanisms of injury and produce, when treated correctly, fairly good results. Although non-displaced stable malleolar fractures are treated safely by conservative means, displaced unstable fractures are still the domain of open reduction and internal fixation (ORIF), as recommended by the AO Group. The principles of the operative treatment of these fractures are discussed in this paper, illuminating the surgical technique and biomechanics of lateral, medial and posterior malleolar fractures. Even though there have been no fundamental changes in the treatment of these fractures in the last several years, new implants such as angular-stable plates and new surgical techniques such as the minimally invasive plate osteosynthesis (MIPO) technique help to treat these fractures more individually, depending on the type of fracture, quality of bone and soft tissue conditions.