Fractures involving the posterior malleolus of the tibia can be difficult to manage. Failure to address these fractures can lead to posterior ankle instability and altered ankle reaction forces. The posterolateral approach to the posterior ankle provides access to both the lateral and posterior malleoli. Displaced fractures of the posterior malleolus can be reduced and fixed under direct visualization through a posterolateral incision. We have had excellent results using this technique for management of displaced posterior malleolar fractures with few complications. Surgeons should be aware of the effectiveness of this technique for managing displaced fractures of the posterior malleolus.
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