Thirty-eight patients in whom a fracture of the posterior malleolus was
shown to comprise 25 per cent or more of the articular surface on the
lateral radiograph were followed for an average of forty-four months
(range, twenty-four to ninety-nine months). All injuries were judged to be
a result of external rotation or abduction of the talus. Fifteen patients
had fixation of the posterior malleolus, and twenty-three did not. Open
reduction and internal fixation was carried out on all associated fractures
of the medial and lateral malleoli. Satisfactory reduction of the posterior
malleolus was often achieved when the fibula was reduced, and frequently
this was maintained despite the absence of fixation. No posterior
subluxation of the talus occurred in either group. No statistically
significant difference was noted between the clinical results with and
without fixation.