Published: 2017-04-26

Assessment of incidence of occurrence of fractures of posteriors malleolus region: a retrospective analysis

Rajneesh Jindal


Background: Fracture of ankle joint involving posterior malleolus easily causes traumatic arthritis and prognosis of this fracture is poor. There are a number of controversies regarding the indications for fixation of fragments of posterior malleolus. Some studies report that if the articular surface at the distal end of the tibia accounts for more than twenty five percent, then fixation of posterior malleolus fragments should be done. In this retrospective study we evaluated the treatment effect of ankle joint fractures involving the posterior malleolus and analyzed the impact of different posterior malleolus fragment sizes on the treatment effect.

Methods: A total of 52 subjects, including 23 males and 29 females, were selected for the present study. Patients with a definitive diagnosis of ankle joint fracture with involvement of the posterior malleolus and undergoing open reduction internal fixation surgery for the same were included in the present study. Mean age of the patients was 41.3 years.

Results: Significant results were observed with respect to posterior malleolus fragment size and arthritis score of two groups. Non- significant results were observed with respect to difference in the American Orthopedic Foot and Ankle Society (AOFAS) score, Visual analogue scale (VAS) rating under various conditions and patient satisfaction rating.

Conclusions: Treatment effect on all 52 cases of ankle joint fractures involving posterior malleolus fractures were satisfactorily.

Full Text:



Dutta AK. Introduction to skull. In: Dutta AK, eds. Essentials of Human Anatomy Head and neck Part II. 3rd ed. Calcutta: Current Books International. 1999:1-69.

Mwachaka PM, Hassanali J, Odula P. Sutural morphology of the pterion and asterion among adult Kenyans. Braz J Morphol Sci. 2009;26(1):4-7.

Singh R. Incidence of sutural bones at asterion in adult Indian skulls. Int J Morphol. 2012;30(3):1182-6.

Day JD, Kellog JX, Tschabitscher M, Fukushima T. Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. Neurosurgery. 1996;38:1079-84.

Uz A, Ugur HC, Tekdemir I. Is the asterion a reliable landmark for the lateral approach to posterior fossa? J Clin Neurosci. 2001;8:146-7.

Martinez F, Laxague A, Vida L, Prinzo H, Sgarbi N, Soria VR, et al. Anatomia topografica del asterion. Neurocirgia. 2005;16:441-6.

Leon SG, Rodriguez AN, Avalos RM, Theriot Giron M, Omana REE, Lopez SG. Morphometric characteristics of the asterion and the posterolateral surface of the skull: relationship with dural venous sinuses and neurosurgical importance. Cir Cir. 2013;81:251-5.

Berry AC, Berry AJ. Epigenetic variation in the human cranium. J Anat. 1967;101:361-79.

Kellock WL, Parson PA. A comparison of the incidence of minor nonmetrical cranial variants in Australian aborigines with those of Melanesia and Polynesia. Am J Phys Anthropol. 1970;33(2)235-40.

Gumusburun E, Sevim A, Katkici U, Adiguzel E, Gulec E. A study of sutural bones in Anatolian Ottoman skulls. Int J Anthropol. 1997;12(2):43-8.

Saheb HS, Mavishettar GF, Thomas ST, Prasanna LC, Muralidhar LC, Muralidhar P, Magi. A study of sutural morphology of the pterion and asterion among human adult Indian skulls. Biomed Res. 2011;22(10):73-5.

Sudha R, Sridevi C, Ezhilarasi M. Anatomical variations in the formation of pterion and asterion in south Indian population. Int J Cur Res Rev. 2013;5(9):92-100.

Ucerler H, Govsa F. Asterion as asurgical landmark for the lateral cranial base approaches. J Craniomaxillofac Surg. 2006;34:415-20.

Xia Y, Li X, Han D, Zheng J, Long H, Shi J. Anatomic structural study of cerebellopontine angle via endoscope. Chin Med J. 2007;120(20):1836-9.

Suazo GIC, Zavando MDA, Smith RI. Sex determination using mastoid process measurements in Brazilian skulls. Int J Morphol. 2008;26(4):941-4.

Mwachaka PM, Hassanali J, Odula P. Anatomic position of the asterion in Kenyans for posterolateral surgical approaches to cranial cavity. Clin Anat. 2010;23(1):30-3.

Selman MO. Metric study of the sigmoid sinus plate in relation to suprameatal (Macewan’s) triangle. Iraqi J Med Sci. 2011;9(1):86-91.