Posterior Malleolar Fracture Essay

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Posterior malleolar fractures (PMF) are relatively common injuries with an incidence of 7%-44% among rotational ankle fractures (1-3). It can occur in settings of tri malleolar fractures or in association with pilon fractures as a distinguished posterior column fracture ( 4…….). It can also be presented as an isolated posterior malleolar farcture (5 ). Less satisfactory clinical outcomes and a high risk of degenerative osteoarthritis are reported in literature with posterior malleolus involvement (6-10). Biomechanically, the displaced posterior malleolar fragment causes a decrease in the joint contact area and predisposing the ankle to degenerative changes (11-13). Fixation of the posterior malleolar fractures remains an area of controversy in orthopaedic surgery.…show more content…
In clinical practice, posterior malleolar fractures can be fixed either using the anterior approach with antero-posterior (AP) lag screws or through a direct posterior approach, in which direct reduction and fixation is achieved by using posterior to anterior (PA) lag screws and/or a posterior buttress plate. Very less work has been done to compare the biomechanical stability of the different fixation methods used in recent clinical practice (14). In an effort to shed more light on this issue, we undertook a finite element analysis (FEA) to compare the biomechanical strength of the different fixation methods used for posterior malleolar fracture fixation. We further analyse the effect of different fixation strategies on the size of posterior malleolar
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