Classification and Treatment of the Posterior Malleolus Fractures Involving the Posterior Colliculus of the Medial Malleolus by 3D CT Images

Abstract：Objective To study how to classify the posterior malleolus fractures which extend to the posterior colliculus of the medial malleolus by three-dimensional computed tomography reconstruction(3-D CT)and choose the corresponding surgical approaches according to the classification. Methods From June 2009 to June 2014,44 patients with posterior malleolus frac-tures which extended to the posterior colliculus of the medial malleolus were treated in our hostial. On the basis of the 3D CT images. These fractures were categorized into type A and type B,with the subtypes of number1 and number 2. The classification depends on the relationship of the upper margin of between the posterior malleolar fragments and the tibiofibular syndesmosis osseous upper margin firstly,whether there were fracture lines between the posterior malleolus fragments and the osterior collic-ulus of the medial malleolus or not secondly. The surgical approaches included posteriormedial incisions combing with lateral or posteriolateral incisions. Results According to the Baird-Jackson Ankle Scoring System,the results were rated as excellent in four case,good in sixteen cases,moderate in twenty cases and poor in four case,with the good-excellent rate being 45. 5% . Conclusion 3D CT can help to classify the posterior malleolus fractures involving the posterior colliculus of the medial malle-olus,select the best surgical approaches and achieve satisfactory clinical results.