Trimalleolar fracture

Trimalleolar fracture is one among the three fractures that involve fractures of the ankle, the other two being single malleolar fracture and bimalleolar fracture. When fractures of the medial, lateral malleoli of the tibia occur in conjunction with the injury of posterior malleoli, it is called trimalleolar fracture. Ankle injuries are mostly sports-related and only 15% of those patients who are evaluated for ankle injuries show significant symptoms of a fracture. Hence for proper management of ankle injuries, familiarity with a thorough ligamentous examination and the Ottawa ankle rules are very important.

The primary care physician should be able to differentiate between a stable injury and an unstable injury. A ring is formed around the ankle mortise by the bones and ligaments. Diagnosis and treatment for trimalleolar fracture need careful examination of the patient. Some important facts like whether the injury was due to inversion or eversion or due to internal or external rotation of the foot should be gathered by questioning the patient. If the patient is able to recall these details, it will be useful to assess patient's stability. Yet another important information the patient can provide is whether he or she could bear weight after injury, since it is specified in the Ottawa ankle rules that inability to bear weight after the injury indicates the need for radiographic examination. Casting or surgical correction are the two options of treatment available for patients who suffer trimalleolar fracture.