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  • Title: Posterior malleolar ankle fractures: an in vitro biomechanical analysis of stability in the loaded and unloaded states.
    Author: Scheidt KB, Stiehl JB, Skrade DA, Barnhardt T.
    Journal: J Orthop Trauma; 1992; 6(1):96-101. PubMed ID: 1556631.
    Abstract:
    The use of internal fixation for posterior malleolar fractures remains controversial. This study assessed the contribution of the posterior malleolus/posterior tibiofibular (PM/PTF) complex to ankle stability in the loaded condition. Total plantarflexion and dorsiflexion, torsion, version, and drawer were measured with 15- and 70-kg loads before and after creation of posterior malleolar fractures that measured 25% of the distal articular surface. After internal fixation, specimens were retested. Fractures caused significant increases with internal rotation and posterior drawer at 15- and 70-kg loads in the neutral position. External rotation, anterior drawer, and dorsiflexion increased at 15-kg load. Fixation increased stability of fractured specimens, but not significantly. Fractures of the PM/PTF ligament complex may lead to excessive internal rotation and posterior instability in the loaded state.
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