Injuries of bones and/or ligaments are known as malleolar fractures. The reason why such fractures occur is due to axial, transitional, and rotational forces either applied directly or indirectly. But the most common cause of malleolar fractures is due to indirect forces. Such a condition could occur due to the twisting of bone during walking, running, or sports activities.

When we talk about the most common malleolar fracture, then it is the lateral malleolus fracture which is also known as an ankle fracture. This fracture occurs when the lateral malleolus gets broken (the bumpy area outside the ankle). While on the other hand, the second-most common type of such fracture is bimalleolar ankle fracture where both the lateral and medial malleolus gets broken.

Before we move on to our next section, let us have a brief look at the symptoms of malleolar fractures.

Symptoms

• Deformity near the ankle area
• Swelling
• Discomfort and pain while walking
• Hematoma

The Treatment

Malleolar fractures are also considered articular fractures and in such conditions, cells and matrix damage could occur that too without any visible disruption of the joint surface.

Now, when it comes to the treatment of stable lateral malleolus fractures, surgery is not required. The goal of treatment is to restore normal joint anatomy and in case of stable fractures, this could be done without surgical procedures. In case of an unstable displaced fracture, open reduction and internal fixation technique is considered the best. Whereas closed methods are used for the treatment of stable undisplaced fractures. The surgical procedure often requires the use of Trauma Implants.

But it won’t be wrong to say that the decision to operate will also depend upon several factors including the condition of the ankle joint and patient’s age along with other health issues like diabetes & osteoporosis.

Let us now have a look at the classification of malleolar fractures to get a better understanding.

Classification of Malleolar Fractures

Infra-syndesmotic fibular fracture

This type of fracture occurs below the syndesmotic ligaments.

Trans-syndesmotic fibular fracture

This condition arises due to the fracture between anterior and posterior syndesmotic ligaments.

Supra-syndesmotic diaphyseal fibular fracture

It is the fracture that occurs above syndesmotic ligaments.

What is Syndesmosis Ligament?

Located near the ankle joint between the tibia and distal fibula, syndesmosis is a fibrous joint and is held together by ligaments. It is also known as distal tibiofibular syndesmosis. The syndesmotic ligaments are of two types:

• Posterior tibio-fibular ligament
• Anterior tibio-fibular ligament

The interosseous membrane is also a part of syndesmosis that helps in holding the tibia and fibula in their correct anatomical position.

So, during reduction, the goal is to bring back the articular congruity to ensure correct positioning of the ankle joint. Your trusted podiatrist Gold Coast can help you treat this kind of condition.

Now, before we wind up, let us see some conditions where operative and non-operative treatment for malleolar fractures is prescribed.

Indications for Non-Operative Treatment

• In case of stable and undisplaced fractures
• When there is no clinical injury of the medial ligament
• In patients suffering from diabetes and impaired circulation (Healing process is delayed in such patients)
• Unfit patients or patients with swollen limbs

Indications for Operative Treatment

• Articular fractures
• Unstable fractures
• Displaced fractures

During open reduction and internal fixation (ORIF) surgery, it is important to consider the condition of soft tissues. The surgical procedure is only preferred when the soft tissues are in good condition allowing complication-free surgery.

Wrapping It Up

Malleolar fractures can range from small bone breaks to complicated dislocations and based on that the treatment procedure is decided. In this post, we have tried to discuss the basics of malleolar fractures along with the type of treatment indicated based on the patient’s condition. We hope our purpose of framing this post has been fulfilled and so does yours of landing here.

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