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Updated: Jan 19, 2026
Ankle Exam: Talar tilt, Anterior drawer, Squeeze, Thompson Tests
Published on: April 30, 2023
The effect of computerised tomography on operative planning in posterior malleolus ankle fractures
Hassaan Q Sheikh1, Edward J Mills1, Jonathan C McGregor-Riley1
1Trauma and Orthopaedic Unit, Sheffield Teaching Hospitals, Herries Road, Sheffield, S5 7AU, United Kingdom.
Background:
The aim of this project was to analyse whether a CT influences surgical planning in ankle fracture involving the posterior malleolus.
Methods:
Twenty consecutive patients with fractures involving the posterior malleolus were retrospectively selected and had their plain radiographs and CT scan anonymised. Initially, radiographs alone were presented to nine trauma surgeons to formulate a surgical plan individually. After a minimum of 6 weeks, the same process was repeated with CT scans available.
Results:
The surgical approach for ankle fracture fixation changed in 32.7% of cases following CT scan review. A CT scan altered the decision to stabilise the posterior malleolus in 25.6% and the decision of whether to stabilise the syndesmosis in 16.6% of cases.
Conclusions:
This study demonstrates that a pre-operative CT scan changes the surgical approach in 32.7% of cases and therefore we recommend use of CT scanning in this subset of ankle injuries.
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