Trimalleolar Fracture: (Cotton Fracture)

- See: Operative Treatment of Posterior Malleolar Fractures

- Discussion:
- involves frxs of medial malleolus & fibula, along w/ frx of posterior lip of articular surface of tibia is frxed & displaced, allowing posterior & lateral displacement and external rotation w/ supination of the foot;
- medial malleolus may remain intact with a tear of the deltoid ligament occuring instead of malleolar fracture;
- same indications for ORIF apply to trimalleolar fx as bimalleolar frx;

- Indications for Surgery

- Operative Treatment of Posterior Malleolar Fractures

Instability of the distal tibiofibular syndesmosis after bimalleolar and trimalleolar ankle fractures.

The Joint-Contact Area of the Ankle. The Contribution of the Posterior Malleolus.

Posterior malleolar fractures of the ankle associated with external rotation-abduction injuries. Results with and without internal fixation.