{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:32:41Z","timestamp":1793327561215,"version":"4.5.0"},"reference-count":135,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n \n \n \u00bb In patients with ankle fractures, the presence of a posterior malleolar fracture has a negative impact on the prognosis.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Computed tomography (CT) scanning is essential for fracture classification and treatment planning, as the indication for surgery depends on the 3-dimensional fragment outline and displacement, incisura involvement, and the presence of joint impaction.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Anatomic reduction of a posterior malleolar fragment restores the incisura, facilitating reduction of the distal part of the fibula, and it also restores the integrity of the posterior portion of the syndesmosis, reducing the need for additional syndesmotic stabilization.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Direct open reduction and fixation of posterior malleolar fragments from a posterior orientation is biomechanically more stable and provides a more accurate reduction than does indirect reduction and anterior-to-posterior screw fixation.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Intra-articular step-off of \u22652 mm is an independent risk factor for an inferior outcome and the development of posttraumatic arthritis, irrespective of the fragment size.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>","DOI":"10.2106\/jbjs.rvw.19.00207","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T12:43:09Z","timestamp":1598618589000},"page":"e19.00207-e19.00207","source":"Crossref","is-referenced-by-count":109,"title":["Posterior Malleolar Fractures"],"prefix":"10.2106","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-6493","authenticated-orcid":false,"given":"Stefan","family":"Rammelt","sequence":"first","affiliation":[{"name":"University Center of Orthopaedics and Traumatology, University Hospital Carl Gustav Carus Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-1443","authenticated-orcid":false,"given":"Jan","family":"Barton\u00ed\u010dek","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, First Faculty of Medicine, Charles University and Central Military Hospital Prague, Prague, Czech Republic"},{"name":"Department of Anatomy, First Faculty of Medicine, Charles University Prague, Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8]]},"reference":[{"issue":"11","key":"r1-20230807","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1097\/00005373-198911000-00018","article-title":"Fractures of the posterior tibial margin: their role in the prognosis of malleolar fractures","volume":"29","author":"Jaskulka","year":"1989","journal-title":"J Trauma"},{"issue":"1","key":"r2-20230807","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3109\/17453679809002355","article-title":"Adult ankle fractures\u2014an increasing problem?","volume":"69","author":"Court-Brown","year":"1998","journal-title":"Acta Orthop Scand"},{"issue":"4","key":"r3-20230807","first-page":"243","article-title":"[Fracture-dislocations of the ankle joint in adults. 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