Management of Isolated Lateral Malleolus Fractures

Amiethab A. Aiyer, Erik C. Zachwieja, Charles M. Lawrie, Jonathan R.M. Kaplan

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


Isolated lateral malleolus fractures represent one of the most common injuries encountered by orthopaedic surgeons. Nevertheless, appropriate diagnosis and management of these injuries are not clearly understood. Ankle stability is maintained by ligamentous and bony anatomy. The deep deltoid ligament is considered the primary stabilizer of the ankle. In the setting of an isolated lateral malleolus fracture, identifying injury to this ligament and associated ankle instability influences management. The most effective methods for assessing tibiotalar instability include stress and weight-bearing radiographs. Clinical examination findings are important but less reliable. Advanced imaging may not be accurate for guiding management. If the ankle is stable, nonsurgical management produces excellent outcomes. In the case that clinical/radiographic findings are indicative of ankle instability, surgical fixation options include lateral or posterolateral plating or intramedullary fixation. Locking plates and small or minifragment fixation are important adjuncts for the surgeon to consider based on individual patient needs.

Original languageEnglish
Pages (from-to)50-59
Number of pages10
JournalJournal of the American Academy of Orthopaedic Surgeons
Issue number2
StatePublished - Jan 15 2019


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