Malleolar fractures are commonly encountered in emergency medicine. They typically result from twisting injuries.
- Two-thirds are isolated to the lateral malleolus (distal fibula)
- One quarter are bimalleolar (also involving the medial malleolus)
- 7% are trimalleolar (lateral and medial malleolus plus posterior distal tibia)
- 2% are open fractures
The primary issue when assessing these injuries is ankle stability. Fractures are less stable when:
- fibula fractures are at or proximal to the tibia-fibula syndesmosis
- medial and lateral ankle injury is present.