The posterior malleolus component of a fracture
of the ankle is important, yet often overlooked. Pre-operative CT scans
to identify and classify the pattern of the fracture are not used
enough. Posterior malleolus fractures are not difficult to fix.
After reduction and fixation of the posterior malleolus, the articular
surface of the tibia is restored; the fibula is out to length; the
syndesmosis is more stable and the patient can rehabilitate faster.
There is therefore considerable merit in fixing most posterior malleolus
fractures. An early post-operative CT scan to ensure that accurate
reduction has been achieved should also be considered. Cite this article:
The results of the DRAFFT (distal radius acute
fracture fixation trial) study, which compared volar plating with
Kirschner (K-) wire fixation for dorsally displaced fractures of
the distal radius, were published in August 2014. The use of K-wires
to treat these fractures is now increasing, with a concomitant decline
in the use of volar locking plates. We provide a critical appraisal of the DRAFFT study and question
whether surgeons have been unduly influenced by its headline conclusions. Cite this article:
