Posterior Malleolar Fractures - The Case for Fixation

Description

This presentation, led by Lyndon Mason from the Liverpool University Hospital Foundation Trust, delves deep into posterior malleolar fractures and their treatment, reflecting on Mason's five years of dedicated research in the field. He begins by extending gratitude to his collaborators, particularly Andy Malloy, acknowledging the collaborative effort behind the presented insights. Mason shares his credentials and discloses his affiliation as an implant designer for the volition ankle fracture system and a consultant for Stryker and Johnson and Johnson, emphasizing the significance of addressing two major risks in orthopedics: unchallenged dogma and fleeting fads.



As the lecture progresses, Mason presents historical data regarding posterior malleolar fractures, highlighting the poor outcomes associated with these injuries prior to 2017, primarily due to a lack of understanding and proper fixation techniques. He discusses the evolution of surgical approaches, classification systems, and the necessity of CT imaging for better diagnosis and treatment planning, dismissing the notion that fracture size dictates outcomes.



Mason introduces a novel classification system for posterior malleolar fractures based on recent studies, categorizing them into distinct types based on injury mechanics. The talk covers important surgical techniques, such as the indirect approach to fixation and the importance of maintaining anatomical alignment during surgery to ensure optimal recovery and function.



Through detailed examples and case studies, Mason discusses the implications of inadequate reduction and fixation techniques while stressing that achieving a stable anatomical reduction is paramount in improving patient outcomes. He concludes by reiterating the importance of ongoing research into fracture morphology, the necessity of advanced imaging techniques, and the future direction of arthroscopic interventions in treating complex ankle fractures. The presentation ends on a hopeful note for further discussions and debates upon concluding the formal lecture.

Specialties