When and how to operate the posterior malleolus fragment in trimalleolar fractures: a systematic literature review

Archives of Orthopaedic and Trauma Surgery
Sander VerhageInger B Schipper

Abstract

Whether or not and how to fixate the posterior malleolus fracture seems to depend on the fracture fragment size and its amount of dislocation, but clear guidelines for daily practice are lacking. In this review, we summarize the literature on preferred treatment of the posterior fragment in trimalleolar fractures. A systematic review of publications between January 1995 and April 30 2017 on this topic in the PubMed, Embase, and Cochrane databases was performed according to the PRISMA statement. Seventeen (2 prospective and 15 retrospective) of the 180 identified studies were included. Six studies report on indications for fixation of posterior malleolus fracture fragments. Eleven studies compare different fixation approaches and techniques for the posterior fragment. Meta-analysis was not possible due to varying fixation criteria and outcomes. There was no clear association between posterior fragment size and functional outcome or development of osteoarthritis. The non-anatomical reduction of the fragment was of more influence on outcome. Radiological and functional outcome was better after open reduction and internal fixation via the posterolateral approach than after percutaneous anterior-to-posterior screw fixation. The post...Continue Reading

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Citations

Aug 31, 2020·The Bone & Joint Journal·Robin P BlomUNKNOWN EF3X-trial Study Group
Jan 24, 2020·World Journal of Clinical Cases·Qi-Hang SuCong Li
May 10, 2020·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Jianguang PengAshish Shah
Nov 19, 2020·Foot & Ankle International·Kristian PilskogJonas Meling Fevang
Feb 6, 2021·Foot and Ankle Clinics·Guillermo Martin Arrondo, German Joannas
Mar 26, 2021·Operative Orthopädie und Traumatologie·S F BaumbachH Polzer
Apr 10, 2021·Archives of Orthopaedic and Trauma Surgery·Annika Pauline Neumann, Stefan Rammelt
Apr 20, 2021·Journal of the American Podiatric Medical Association·Fırat FidanUfuk Ozkaya
Sep 4, 2020·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·T D StringfellowUNKNOWN Posterior Malleolus Study Group

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