Some fractures involve both bones; others affect only one.
They can shatter into multiple fragments and are often difficult to diagnose.
Moreover, there is little consensus on how best to stabilize the fracture once it has been reset.
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All told, isolated posterior malleolus fractures account for only around 1% of ankle fractures.
More often, breaks will occur when the medial and lateral malleolus are also involved.
This is commonly referred to as a trimalleolar fracture in which all three bone structures are broken.
It is considered a serious injury which is often accompanied by ligament damage and dislocation of the ankle.
It will be this fragment where fixation efforts will be focused.
Surgery will often be required to ensure the fragments are correctly placed.
With that being said, there remains controversy as to when it is most appropriate.
Traditionally, surgeons have long recommended surgery if more than 25% of the malleoli is involved.
This allows your surgeon to reposition the fragments and secure them with plates and screws.
Rehabilitation
Rehabilitationis similar to that used for other types of ankle fracture.
Typically, surgeons will immobilize the ankle and allow the incisions to heal before initiating physical therapy.
This is why postoperative care will often require the ankle to be non-weight-bearing for six weeks.
Total recovery time is between four to six months, although it may take longer for more severe injuries.
Podiatry Today.Treating complicated ankle fractures.
American Academy of Orthopaedic Surgeons.Ankle fractures (broken ankle).
A survey of OTA members.Journal of Orthopaedic Trauma.
2017;31(4):e116-e120.
