Trimalleolar Fracture – 28F

Nothing really that remarkable about this case except the fact that the anterior colliculus fracture was the hardest part of this tri-mall to reduce. Getting the posterior mall, and the fibula out to length were simple with a Hintermann, despite the comminution at the lat malleolus.

However, once we flipped the patient supine, it took the same time supine as it did prone. When we started to reduce the colliculus it would want to rotate. Maybe in hindsight a small hook plate would be helpful?

If you look closely at the lateral you can see the posterior aspect of the colliculus fracture is not perfectly reduced. We elected to use a single 3.0 screw as that’s all we could squeeze in.