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Wheeless' Textbook of Orthopaedics

Trimalleolar Frx: (Cotton Frx)



- See: Operative Treatment of Posterior Malleolar Fractures:

- Discussion:
    - involves frxs of medial malleolus & fibula, along w/ frx of posterior lip of articular surface of tibia
            is frxed & displaced, allowing posterior & lateral displacement and external rotation w/ supination of the foot;
    - medial malleolus may remain intact with a tear of the deltoid ligament occuring instead of malleolar fracture;
    - same indications for ORIF apply to trimalleolar fx as bimalleolar frx;

- Indications for Surgery:

- Operative Treatment of Posterior Malleolar Fractures:






Instability of the distal tibiofibular syndesmosis after bimalleolar and trimalleolar ankle fractures.

The Joint-Contact Area of the Ankle.   The Contribution of the Posterior Malleolus.

Posterior malleolar fractures of the ankle associated with external rotation-abduction injuries. Results with and without internal fixation.




Original Text by Clifford R. Wheeless, III, MD.