Posterior Malleolus - The Case for Leaving Most Alone

Description

The seminar led by Tim White focuses on the complexities of posterior malleolus fractures, highlighting the recent surge in interest and publication surrounding this topic, particularly since 2006. The discussion addresses the impulsive approach to surgical interventions prompted by an x-ray diagnosis of posterior malleolus fractures, emphasizing the need for a more judicious evaluation before proceeding to CT scans and surgeries. With a significant complication rate associated with interventions, illustrated by a case of a young woman who underwent multiple surgeries leading to amputation, White cautions against the assumption that every posterior malleolus fracture requires surgical fixation. He references established classification systems, like Haraguchi and Bartonicek, proposing protocols that advocate for conservative treatment in the vast majority (over 80%) of cases that do not exhibit significant displacement or instability. White concludes that while selective fixation may be required for specific types of fractures, a more critical assessment of cases is necessary before widespread surgical adoption in order to minimize risks and complications.

DOI: 10.1302/3114-230446

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