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Ankle

Fractures

Mid Tibial Fractures

CT

Is useful as significant incidence of radiographic occult fractures extending to the pilon. 1 - Posterior malleolar fractures in 70% of spiral tibial shaft. - 50% of these fractures were missed on radiographs.

And, there is debate about need to stabilise this fragment which separates out the posterior malleolus. 1 - Some say 25% of surface area -> ORIF. - Others based on stability & displacement.

  1. Wang Z, Chen W, Zhu Y, et al. Incidence and missed diagnosis risk of occult posterior malleolar fractures associated with the tibial shaft fractures: a systematic review. J Orthop Surg Res. 2021;16(1):355. Published 2021 Jun 1. doi:10.1186/s13018-021-02502-6 ↩↩