Posterior malleolar fractures of the ankle associated with external rotation-abduction injuries. Results with and without internal fixation.

Thirty-eight patients in whom a fracture of the posterior malleolus was shown to comprise 25 per cent or more of the articular surface on the lateral radiograph were followed for an average of forty-four months (range, twenty-four to ninety-nine months). All injuries were judged to be a result of external rotation or abduction of the talus. Fifteen patients had fixation of the posterior malleolus, and twenty-three did not. Open reduction and internal fixation was carried out on all associated fractures of the medial and lateral malleoli. Satisfactory reduction of the posterior malleolus was often achieved when the fibula was reduced, and frequently this was maintained despite the absence of fixation. No posterior subluxation of the talus occurred in either group. No statistically significant difference was noted between the clinical results with and without fixation.