Operative versus non-operative treatment of Malleolus Fractures

Isolated non-displaced infra-syndesmotic (type A) fractures of the distal fibula that do not involve the medial side is stable and can be treated non-operatively. Isolated non-displaced trans-syndesmotic (type B) fractures of the lateral malleolus that do not involve the medial side can be treated non-operatively, provided that the ankle mortise remains congruent. The determination of whether the deltoid ligament has been disrupted relies upon clinical findings of tenderness on the medial side. If this is associated with evidence of a displaced mortise, then treatment should be operative stabilization of the fibula