M.E.Müller: Atlas: Fracture 44-A3

Tibia/Fibula, malleolar segment,
infrasyndesmotic lesion,
with postero-medial fracture 6 % of segment

Rupture lateral collateral ligament Avulsion tip lateral malleolus Transverse fx lateral malleolus

These are infrasyndesmotic lesions of the lateral malleolus, either ligamentous or bony, associated to a posteromedial fracture. The lateral lesion may be a ligament rupture (.1), an avulsion fracture of the tip of the malleolus (.2) or a transverse fracture (.3). Ref. Manual of Internal Fixation:
595 - 611.
Surgeon. MS, RO, MS.

The ligamentous ruptures are repaired by direct suture. The avulsions of small fragments should always be fixed, because otherwise they will evolve into a pseudoarthrosis (traction). The tension band internal fixation is the ideal

technique. The tension band can also be applied to the transverse fractures of both malleoli but, whenever the fragments are large enough, it is preferable to use cancellous lag screws.

preoperative + 1 year + 1 year

preoperative + 1 year + 1 year

preoperative + 1 year + 1 year




						Tibia/Fibula, malleolar segment, infrasyndesmotic lesion, with postero-medial fracture	6 % of segment






These are infrasyndesmotic lesions of the lateral malleolus, either ligamentous or bony, associated to a posteromedial fracture. The lateral lesion may be a ligament rupture (.1), an avulsion fracture of the tip of the malleolus (.2) or a transverse fracture (.3).		Ref. Manual of Internal Fixation: 595 - 611. Surgeon. MS, RO, MS.

The ligamentous ruptures are repaired by direct suture. The avulsions of small fragments should always be fixed, because otherwise they will evolve into a pseudoarthrosis (traction). The tension band internal fixation is the ideal	technique. The tension band can also be applied to the transverse fractures of both malleoli but, whenever the fragments are large enough, it is preferable to use cancellous lag screws.