Focus on osteo-ligamentous injuries around the ankle

Excerpt

Ankle fractures and ligamentous injuries at the lateral ankle are among the blockbusters in trauma of the lower leg [1]. The intermediate and long-term outcome with around 10 % of patients with symptomatic osteoarthritis is not that good as often presumed [2]. Despite the ubiquitous high incidence of malleolar fractures and in knowledge of the fact that with increasing number of the involved malleoli, in particular, of the posterior ankle and the need for placing a positioning screw, the prognosis is getting worse and evidence-based recommendations for treatment are lacking [1, 3‐5]. Presence of fracture dislocation at injury, articular surface congruity and residual talar subluxation are obviously relevant prognostic parameters [3]. Of course, the mantra of anatomical and functional restoration of any particular lesion may represent our general guideline for treatment of ankle fractures, but, it does hardly substitute the need for prospective multicentre studies to clarify the prognostic value of fragment size which has been regarded as a relevant parameter for decision making in refixation of posterior malleolar fractures for decades [3, 4]. …