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The aim of this study was to evaluate the medium-term outcomes of malleolar fractures involving the AM.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Among 100 patients with AM fractures\u00a0that were treated over a 10-year period, 50 patients were available for follow-up. Outcome was assessed with the Olerud Molander Ankle Score (OMAS), the Foot Function Index (FFI-D), the EuroQol (EQ)-5D-5L Index, the EQ-VAS and the AOFAS Ankle-Hindfoot Score. Type 1 AM fractures (bony syndesmotic avulsions) were fixed surgically with either a suture anchor or a transosseous suture in 11 of 22 cases (50%). Among type 2 AM fractures (with incisura and joint involvement), 68% were treated surgically with screw fixation. All three type 3 AM fractures (anterolateral tibial plafond impaction) were treated surgically with either screw or plate fixation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>At follow-up, the median OMAS was 75, the FFI-D 19, the EQ-5D-5L-Index 0.88, the EQ-VAS 70, and the AOFAS score 93. Assuming that the fracture severity increases from Supination\u2013External Rotation to Pronation\u2013External Rotation and Pronation\u2013Abduction injuries, the AOFAS score (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), OMAS score (<jats:italic>p<\/jats:italic>\u2009=\u20090.009), and FFI-D (<jats:italic>p<\/jats:italic>\u2009=\u20090.041) all showed a significantly inferior clinical outcome with increasing fracture severity. Patients who required surgical revision (<jats:italic>n<\/jats:italic>\u2009=\u20095) showed a significantly inferior outcome with the OMAS\u00a0(<jats:italic>p<\/jats:italic>\u2009=\u20090.019).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>A differentiated treatment protocol tailored to dislocation, size, incisura involvement and joint impaction leads to favourable outcomes in complex malleolar fractures involving the AM. More data are needed on the outcome of AM fractures that are still commonly underestimated and overlooked.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-022-02161-0","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T23:04:40Z","timestamp":1669158280000},"page":"941-949","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Ankle fractures involving the anterolateral distal tibia: medium-term clinical results of 50 cases"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9838-8378","authenticated-orcid":false,"given":"Livia","family":"Kroker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2488-1805","authenticated-orcid":false,"given":"Annika Pauline","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-3666","authenticated-orcid":false,"given":"Franziska","family":"Beyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-6493","authenticated-orcid":false,"given":"Stefan","family":"Rammelt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"2161_CR1","doi-asserted-by":"publisher","first-page":"10443","DOI":"10.1038\/s41598-018-28722-1","volume":"8","author":"S Liu","year":"2018","unstructured":"Liu S, Chen W, Wang L, Zhang X, Zhang Y. 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Annika Pauline Neumann reports no potential conflicts of interest. Franziska Beyer reports no potential conflicts of interest. Stefan Rammelt receives travel support from AO Trauma to courses and meetings as member of AO faculty. He is a consultant for KLS Martin and 3\u00a0M. He received travel support and honorarium for a lecture from Siemens Healthineers. No conflict of interest results for the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest statement"}}]}}