Isolated posterior malleolus fracture – magnetic resonance imaging diagnosis

January 14, 2022 Radiology & Cancer Therapy No Comments

Approximately 7% to 44% of ankle fractures involve the posterior tibial margin. These
fractures tend to have a poorer prognosis than fractures without posterior involvement.
Recognition of posterior malleolar fracture patterns is more important than fracture
fragment size in decision making. Standard ankle radiographs are not effective for
diagnosing isolated posterior malleolar fractures. There is consensus that the true size and
geometry of the fragment, specifically its medial propagation, and intercalary fragments
may be diagnosed only by computed tomography scanning. Magnetic resonance imaging
may yield additional information about syndesmotic ligaments, tendons and osteochondral
lesions, although it is used only exceptionally. There are controversies about the treatment
of these fractures but authors agree that small fragments can be treated conservatively
whereas larger fractures that involve more than 25% of articular surface should be fixed
to avoid instability and degenerative changes. The authors report a case with a magnetic
resonance imaging diagnosis of this fracture.

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