Posterior malleolar fractures should be fixed regardless the size, considering some individual factors. Surgeon should consider factor may influence functional outcomes. Surgical fixation of unstable ankle fractures should always be performed within the first 48 hours from the trauma, preventing instability and post-traumatic osteoarthritis. ResultsĪll the outcomes of the thirty-three selected studies were analyzed. The quality of the studies was evaluated with the Methodological Index for Non-randomized Studies (MINORS) questionnaire. Studies were included if they reported on: (1) bimalleolar or trimalleolar fracture in adults (2) treatment (3) outcomes reported by scales (4) follow-up. The electronic databases PubMed, Scopus, and Embase were interrogated using the search terms “bimalleolar” or “trimalleolar” and “fracture”. Questions/purposesįor this systematic review we asked: (1) What are the outcomes in treatment of unstable ankle fractures? (2) What about complications of treatment in unstable fractures? (3) What factors influence the outcomes? (4) What about the role of the posterior malleolus? Methods Given the instability, they often require surgical treatment, but literature scarcely reports on the outcomes of their management. Unstable ankle fractures are very frequent.
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