Modified posteromedial approach for combined posterior and lateral malleolar fixation in complex ankle fractures: A technical insight apropos a single clinical case

Abstract

The fixation of posterior malleolar fractures has gained increased relevance over the past decade due to its essential role in restoring ankle joint stability and function. Various approaches and fixation strategies have been described in the literature, typically requiring multiple incisions, thereby increasing the complexity and risk of soft-tissue complications. The aim of this study is to present a technical note describing a single modified posteromedial approach for combined posterior, medial, and lateral malleolar fixation in complex ankle injuries. This technical note outlines the surgical steps of a modified posteromedial approach that enables the fixation of all three malleoli through a single incision. The approach provides access to posterolateral, posteromedial, and medial distal tibial surfaces as well as the lateral malleolus. The technique is demonstrated in a single representative clinical case of a complex trimalleolar ankle fracture. Level of evidence V; Expert Opinion.