1. Case for small group discussion
Ankle fracture
Case for small group discussion
Ankle fracture with posterior malleolus impaction
AOTrauma—Foot & Ankle
Module 1a: Ankle trauma—ankle fractures
Stefan Rammelt, DE

2. Case description 33-year-old woman Skiing injury Soft tissues closed
No significant swelling
Are additional investigations needed?

3. CT-scans Treatment options? Timing? Surgical approaches?
Type of fixation?

4. Discuss surgical approaches

5. Stability through posterior syndesmosis fixation

6. Take-home messages
Generous use of CT scans for posterior malleolar fractures
Posterior approach when there is impaction
Fixation with screws or buttress plate depends on fragment size and bone quality
Stable fixation of posterior malleolus also results in syndesmotic stability
Reconstruction of the posterior malleolus also reconstructs the tibial incisura
References:
Bartoníček J, Rammelt S, Tuček M, et al. Posterior malleolar fractures of the ankle.
Eur J Trauma Emerg Surg Dec;41(6):
Rammelt S, Obruba P. An update on the evaluation and treatment of syndesmotic injuries. Eur J Trauma Emerg Surg Dec;41(6):
Bartonicek et al. Eur J Trauma Emerg Surg. 2015;
Rammelt et al. Eur J Trauma Emerg Surg. 2015;