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Fractures of the posterior malleolus are common in ankle fractures. Its fixation is important for syndesmotic stability and plays an important role in the prevention of post-traumatic arthrosis and, consequently, leads to a better functional outcome.
Reduction quality is best if you use a backtrack compared to usual techniques.
We report the case of a 52-year-old male with a tibial pilon fracture AO/OTA 43C3 and Bartonicek type 3. The anatomical reduction and fixation of the posterior malleolus was performed through a posteromedial approach, with good functional results 9 months postoperatively.
The posteromedial approach is a safe way to reduce and fix the posterior malleolus, which also allows the reduction and fixation of the remaining distal tibia, allowing a rapid functional recovery and minimizing late degenerative complications.