Posterior malleolar fractures

Abstract Posterior malleolus fractures are increasingly recognized as a key determinant of ankle stability and long-term functional outcomes. Traditional size-based indications for fixation have been challenged by advances in imaging and biomechanical understanding.

Objective

To provide a comprehensive and critical overview of current concepts in the diagnosis, classification, and treatment of posterior malleolus fractures.

Methods

A narrative review of contemporary literature was conducted, focusing on systematic reviews, biomechanical studies, and clinical outcome analyses.

Results

Evidence supports CT-based morphological assessment over fragment size alone. Direct posterior fixation offers improved articular reduction and syndesmotic stability in selected cases.

Conclusion

Management should be individualized based on fracture morphology, stability, and joint congruency. Anatomical reduction remains the cornerstone of optimal outcomes.