الفهرس 
Osteology of the ankle jointOnly 14 pages are availabe for public view
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Abstract
Summary
Posterior malleolar fractures challenge the structural integrity of the posterior syndesmotic ligaments; as 42% of syndesmotic stability is provided by the posterior inferior tibio-fibular ligament. Fixation of posterior malleolar fracture is indicated with fragment size ranging from 20% to 33% of tibial plafond.
Different operative techniques are proposed for such fractures, with the most commonly used technique being indirect antero-posterior screw fixation, also direct postero-anterior screw fixation, and buttress plate are used. However, direct reduction and Posterolateral plate fixation offers more anatomical reduction, rigid fixation and more syndesmotic stability.
In this prospective study, we present 15 patients with closed posterior malleolar fractures, managed by plate fixation through posterolateral approach, in the period between August 2017 and August 2018 at the orthopedic surgery department, Tanta University Hospitals.
The fractures were either bimalleolar (SER 3) in 40% of cases, and trimalleolar (SER 4) in 60% of cases. All cases were subjected to pre-operative CT to determine the size and the site of the fragment. The functional outcome of these cases was assessed (after at least six-month follow-up) by a modification of the Baird and Jackson scoring system. This modification was done to fit the life style and usual activities of most of the Egyptian female patients, who comprised more than 70% of cases in this study, since the ”ability to run” and “instability with sports” (as a part of the ankle stability score items) were not applicable questions. In this modification, the maximal possible score was 75, with excellent score: 75-72, Good: 71-68, Fair: 67-60, and Poor: 59-0.