We assessed the long-term (20 years) outcomeof closed reduction and immobilisation in 19?patients with an isolatedfracture of the posterior malleolus of the ankle treated at a singlehospital between 1985 and 1990. The assessments used were an Olerudfunctional questionnaire score, physical examination using a loadeddorsal and plantar range of movement measurement, radiological analysisof medial joint space widening, the Cedell score for anatomicalalignment of all three malleoli, and the radiological presence ofosteoarthritic change. There were excellent or good results in 14 patients (74%) accordingto the Olerud score, in 18 patients (95%) according to loaded dorsaland plantar range of movement assessment, in 16 patients (84%) asjudged by the Cedell score, and for osteoarthritis 18 patients (95%)had an excellent or good score. There were no poor outcomes. There wasno correlation between the size of the fracture gap and the proportionof the tibiotalar contact area when compared with the clinical results(gap size: rho values -0.16 to 0.04, p ≥ 0.51; tibiotalar contactarea: rho values -0.20 to -0.03, p ≥ 0.4). Conservative treatmentof ‘isolated’ posterior malleolar fractures resulted in good clinicaland radiological outcome in this series at long-term follow-up.
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