Isolated Medial Malleolar Fractures: Current Concepts in Management

Isolated medial malleolar fractures (IMMFs) are uncommon and often occur with other ankle injuries, complicating their treatment and management. This review aims to compare the complication rates and functional outcomes of surgical versus conservative treatment for IMMFs in skeletally mature patients. The literature suggests that for IMMFs with less than 2 mm of displacement, conservative treatment provides functional outcomes similar to surgical interventions, with minimal complications. However, for fractures with greater displacement, surgical management is typically preferred due to its superior functional outcomes and low complication rates. Additionally, this review explores the biomechanics of various surgical constructs used to manage IMMFs. It provides insight into the most effective techniques for achieving stable fixation and promoting optimal recovery. By synthesizing evidence from the current literature, this review contributes to the ongoing debate regarding the management of IMMFs, emphasizing the importance of individualized treatment plans based on fracture characteristics and patient factors.