New Concepts in the Surgical Management of Ankle Fractures

ORTHOPEDICS 2008; 31:868 Eddie Y. Lo, MD; Mark A. Lee, MD

Newer studies on surgical management of ankle fractures have given us a greater appreciation of the spectrum of stability for multiple patterns of injury, and newer fixation approaches and techniques may allow us to optimize fixation. Ankle fractures are one of the most common fractures managed by orthopedic surgeons and can be some of the most technically demanding surgical cases. While many of these fractures and their methods of stabilization are uncomplicated, the management of some fracture variants has become increasingly controversial, especially with respect to determinations of instability and optimal fixation techniques. A number of recent studies have altered some of the classic principles and approaches to surgical management. These include new concepts in the evaluation of the medial-side ligament injury, new techniques for medial-sided fixation, reemergence of interest in posterior fixation of the lateral malleolus, new interest in posterior malleolar fixation, new techniques for syndesmosis stabilization, and a new perspective on outcomes after ankle fractures.