Fracture, Posterior Malleolus, Sports Medicine

Kristina Quirolgico, MD Reviewed 04/2019

BASICS

DESCRIPTION

Ankle fracture involving the posterior aspect of the distal tibial articular surface
Also known as posterior pilon fracture

EPIDEMIOLOGY

Isolated posterior malleolus fractures are rare—...

DIAGNOSIS

Diagnosis of posterior malleolar fractures relies on a high degree of clinical suspicion.

HISTORY

Very important to obtain exact mechanism of injury:
- Posterior malleolus fracture has been desc...

TREATMENT

Isolated posterior malleolus fractures and nondisplaced posterior malleolus fractures (<25% of distal tibial articular surface) in bimalleolar/trimalleolar ankle fractures are treated non...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Orthopedic referral should be considered for any isolated fractures of the posterior malleolus because they often are complicated by other injuries.

PATIENT EDUCATION

REFERENCES

Bartoníček J, Rammelt S, Tuček M. Posterior malleolar fractures: changing concepts and recent developments. Foot Ankle Clin. 2017;22(1):125–145.

Odak S, Ahluwalia R, Unnikrishnan P, ...

ADDITIONAL READING

Barelds I, Krijnen WP, van de Leur JP, et al. Diagnostic accuracy of clinical decision rules to exclude fractures in acute ankle injuries: systematic review and meta-analysis. J Eme...

CLINICAL PEARLS

Posterior malleolar fractures rarely occur in isolation, so a high index of suspicion is necessary when lateral or medial malleolar fractures and/or syndesmotic injuries are diagnosed.
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