Vol 3 | Issue 2 |  July-Dec 2018 | Page 44-47 | Nicholas Antao, K.S. Kushalappa, Rajesh Hingwe, Ashish Upadhyay.

Authors: Nicholas Antao [1], K.S. Kushalappa [1], Rajesh Hingwe [1], Ashish Upadhyay [1].

[1] Department of Orthopaedic surgery, Holy Spirit Hospital, Mumbai, Maharashtra

Address of Correspondence
Dr. Nicholas Antao,
Dept. of Orthopaedics, Holy Spirit Hospital, Mahakali Road, Andheri (E), Mumbai – 400093 India.
Email: narantao@gmail.com

Abstract

Introduction: Posterior malleolus fractures mostly occur in association with fractures of other malleoli. The current recommendation is fixation based on the size of the fragment.
Materials & Methods: A retrospective study of 30 cases of posterior malleolus was conducted. There were 4 cases in type 1, 8 cases in Type 2, 7 cases in type 3, 10 cases in Type 4 and Type 5 there was one case. Type 1 were not operated, and type 5 were left alone in POP cast for 6 weeks. Type 2, 3 and 4 were operated either by cannulated cancellous screw by trans-Achilles approach, when the fragment was less than 20% of the surface area in 6 cases. When the surface exceeded 15% , those cases were treated with osteosynthesis by posterolateral approach using a buttress plate principle.
Results: Good results were seen in all cases except one which develop post-operative infection and had early arthritis.
Conclusion: Radiological studies are essential to plan, and posterolateral approach provides a good exposure for management of posterior malleolar fractures
Keywords: Posterior malleolar fracture, fixation, 3D CT scan

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