Reduction Quality in Posterior Malleolar Fractures Using a Modified Posteromedial Ankle Approach

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Anatomical reduction of posterior malleolar fractures is crucial for optimal functional outcomes in ankle fracture management.
• Limited studies have evaluated the reduction quality of posterior malleolar fractures using the modified posteromedial ankle approach via postoperative CT scans.

Purpose of the Study:

• To assess the reduction quality of posterior malleolar fractures treated with the modified posteromedial ankle approach.
• To evaluate syndesmotic reduction and articular step-off using postoperative CT scans.

Main Methods:

• Retrospective case series of 66 patients with Bartonicek types 2, 3, and 4 posterior malleolar fractures.
• Treatment involved the modified posteromedial ankle approach.
• Postoperative CT scans assessed syndesmotic reduction, articular step-off, and residual gap.

Main Results:

• 92% (61/66) of posterior malleolar fractures achieved reduction with <2 mm step-off.
• Syndesmotic reduction was anatomical in 61 patients.
• Four patients had mild anterior fibular translation without reoperation; one had poor syndesmotic malreduction.

Conclusions:

• The modified posteromedial ankle approach is effective for achieving anatomical reduction in posterior malleolar fractures.
• This approach facilitates successful fracture fixation and syndesmotic stability.