The Modified Posteromedial Approach to Posterior Malleolar Fractures

Abstract

Posterior malleolus fractures are known to be caused by a combination of rotation and impaction, resulting in a wide variety of fractures, as published by Bartonicek. Among them is the subgroup known as the “posterior pilon variant,” in which the axial impaction mechanism plays a fundamental role. There is no consensus regarding appropriate surgical approaches for these fractures. We describe a posteromedial modified approach, as an alternative to treat posterior pilon malleolar fractures. This approach can be performed safely, with low complication rates and generally with favorable outcomes. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.