Hi, my name is Felipe Pino, and I'm going to present you reduction quality in posterior malleolar fractures using the modified posterior medial ankle approach. These are my disclosures. As background, we can say that several studies have documented which of the posterior ankle approaches has the best exposure of the posterior malleolus. However, no study has made a correlation between the quality of posterior fragment reduction using postoperative CT scans and the approach used. That's why the purpose of this study was to assess the quality of reduction of posterior malleolus fractures in patients with three malleolar ankle fractures operated with the modified posterior medial approach. In relation to material and methods, a retrospective search was performed in two health centers between 2014 and 2021 for patients with ankle fracture dislocations associated with types 2, 3, and 4 posterior malleolar fractures according to the Bartoni check classification. In relation to the inclusion criteria, patients with full ankle trauma radiographic sets, pre- and postoperative CT scans, and patients with posterior malleolus fractures reduction and fixation using the modified posterior medial ankle approach, all procedures were performed by six experienced foot and ankle surgeons. In relation to results, 48 patients met our inclusion criteria, 29 women and 19 men, and six of them required two-stage management because of soft tissue compromise. In the actual plane evaluation, 11 patients showed a type 2, 31 patients a type 3, and 4 patients a type 4 malleolus fractures in relation to the Bartoni check classification. In relation to the fibular position at the fibular notch, 39 patients showed an adequate reduction and anatomical syndesmotic reduction, and 4 patients showed a diastasis or gap more or equal than 2 millimeters as a consequence of intercalary and redact fragment. In the sagittal plane evaluation, 45 patients showed an anatomical reduction and 3 patients showed a poor reduction as a consequence of posterior malleolus displacement more or equal than 2 millimeters. As a conclusion, we can say and we think that modified posterior medial approach is a good option to manage pre-malleolus ankle fractures since we achieved an anatomic posterior malleolus fracture reduction in 94% of our patients. Thank you.

Felipe Pino

study

reduction quality

posterior malleolar fractures

modified posterior medial ankle approach