Surgical and nonsurgical therapy of malleolar fractures

: Subjective and objective parameters after the treatment of malleolar fractures were studied in 116 patients during a five-year-period. Nonoperative treatment was used in 48 patients and 68 patients were operated. Nonoperative treatment was successful in both supination-eversion and supination-adduction types of fractures, whereas in pronation fractures the operative treatment provided better results. The results were significantly influenced by residual lateral shortening, altered talocrural angle, talar subluxation and the size of posterior fragment. In all types of fractures but in supination-adduction type anatomical reduction and clinical findings correlated. Subjective results are sometimes influenced by factors which cannot be visualized on radiographies.