[The atypical C-malleolar fracture]

Fractures of the ankle in adults are very common. Like every intraarticular fracture, they require perfect reduction and stable fixation to guarantee a good result. In most cases this can only be achieved by open treatment. The classification of ankle fractures according to Weber depends upon whether the fibular fracture is below (type A) at (type B) or above (type C) the syndesmosis. This classification also defines the importance of the tibio-fibular ligaments. From 1978 to 1992 more than 1000 ankle fractures were treated in our clinic by open reduction and fixation: 72 were type C ankle fractures, and the rest, either type A or type B fractures. When we reviewed our type C fractures we found 9 patients with so-called atypical type C fractures; these have an atypical fracture pattern insofar as a fracture of the medial malleolus is combined with tibiofibular ligament lesion and there is no fibula fracture. Definition, diagnosis, treatment and results are presented in this publication.