Supramalleolar fracture of the ankle (Malgaigne's fracture)

A retrospective study of 26 cases of supramalleolar fracture is presented. Types II and III were most common. All but the one had accompanying fibular fracture. The incidence of open fracture was 41.7% (10/24). The most common mechanism of injury was a high energy impacting force in the direction of axial compression. The supramalleolar fracture was subgrouped into four types. Twenty patients were treated by closed reduction and cast immobilization for an average of five months, six by open reduction and internal fixation, and two by skeletal traction in the early course of treatment. Of the 21 patients who were followed for an average of 33 months, only seven were found to have satisfactory results and were free from complications. Fourteen patients were found to have complications.