Treatment Strategy for Posterior Malleolar Fractures: Different Operative Strategies Are Needed for Each...

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• The optimal surgical indication for posterior malleolar fractures (PMFs) is debated.
• Developing tailored treatment strategies based on PMF morphology is crucial.

Purpose of the Study:

• To evaluate midterm outcomes of posterior malleolar fracture treatment.
• To establish treatment guidelines for different PMF morphological types.

Main Methods:

• Retrospective analysis of 472 patients with unstable ankle fractures and PMFs.
• Classification of PMFs using the Haraguchi classification.
• Comparison of outcomes between surgically fixed and non-fixed PMFs within three morphological types.

Main Results:

• Type 1 PMFs: No significant difference in reduction quality, functional, or radiological outcomes between fixation and non-fixation groups.
• Type 2 PMFs: Surgical fixation significantly improved reduction quality, radiological, and clinical outcomes compared to non-fixation.
• Type 3 PMFs: Non-fixation was standard; fixation group showed higher complication rates.

Conclusions:

• Morphology-specific treatment strategies are necessary for posterior malleolar fractures.
• Further research is needed to refine surgical decision-making for various PMF types.