Pflüger Patrick, Braun Karl-Friedrich, Mair Olivia, Kirchhoff Chlodwig, Biberthaler Peter, Crönlein Moritz
Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Department of Traumatology and Reconstructive Surgery including Department of Orthopedic Surgery, Charite Universitätsmedizin Berlin, Berlin, Germany.
EFORT Open Rev. 2021 Aug 10;6(8):692-703. doi: 10.1302/2058-5241.6.200138. eCollection 2021 Aug.
A trimalleolar ankle fracture is considered unstable and treatment is generally performed operatively. Computed tomography is important for the operative planning by providing an elaborated view of the posterior malleolus.Trimalleolar ankle fractures have a rising incidence in the last decade with up to 40 per 100,000 people per year. With a growing number of elderly patients, trimalleolar ankle injuries will become more relevant in the form of fragility fractures, posing a particular challenge for trauma surgeons.In patients with osteoporotic trimalleolar ankle fractures and relevant concomitant conditions, further evidence is awaited to specify indications for open reduction and internal fixation or primary transfixation of the ankle joint.In younger, more demanding patients, arthroscopic-assisted surgery might improve the outcome, but future research is required to identify patients who will benefit from assisted surgical care.This review considers current scientific findings regarding all three malleoli to understand the complexity of trimalleolar ankle injuries and provide the reader with an overview of treatment strategies and research, as well as future perspectives. Cite this article: 2021;6:692-703. DOI: 10.1302/2058-5241.6.200138.
三踝骨折被认为是不稳定的，通常需进行手术治疗。计算机断层扫描对于手术规划很重要，它能提供后踝的详细图像。在过去十年中，三踝骨折的发病率呈上升趋势，每年每10万人中高达40例。随着老年患者数量的增加，三踝骨折将以脆性骨折的形式变得更加常见，这给创伤外科医生带来了特殊挑战。对于患有骨质疏松性三踝骨折及相关伴随病症的患者，仍需进一步证据来明确切开复位内固定或踝关节一期固定的适应症。在更年轻、要求更高的患者中，关节镜辅助手术可能会改善治疗效果，但未来还需要研究以确定哪些患者将从辅助手术治疗中获益。本综述考虑了有关所有三个踝骨的当前科学发现，以了解三踝骨折损伤的复杂性，并为读者提供治疗策略和研究的概述以及未来展望。引用本文：2021;6:692 - 703。DOI: 10.1302/2058 - 5241.6.200138。
