Trimalleolar fracture

Last revised by Craig Hacking ◉ on 6 Jun 2024

Citation, DOI, disclosures and article data

Citation:

Bickle I, Hacking C, Murphy A, et al. Trimalleolar fracture. Reference article, Radiopaedia.org (Accessed on 02 Mar 2025) https://doi.org/10.53347/rID-27657

DOI:

https://doi.org/10.53347/rID-27657

Permalink:

https://radiopaedia.org/articles/27657

rID:

27657

Article created:

12 Feb 2014, Ian Bickle ◉

Disclosures:

At the time the article was created Ian Bickle had no recorded disclosures.

View Ian Bickle's current disclosures

Last revised:

6 Jun 2024, Craig Hacking ◉

Disclosures:

At the time the article was last revised Craig Hacking had the following disclosures:

Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)

These were assessed during peer review and were determined to not be relevant to the changes that were made.

View Craig Hacking's current disclosures

Revisions:

16 times, by 12 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Trauma

Tags:

stub, refs, fracture, ankle

Synonyms:

Trimalleolar ankle fracture
Trimalleolar ankle fractures
Trimalleolar fractures

Trimalleolar fractures refer to a three-part ankle fracture. The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus. Having three parts, it is an unstable fracture and may be associated with ligamentous injury.

Differential diagnosis

Pilon fracture ¹

Practical points

measuring the size of the fracture fragment as a percentage of the total articular surface on the lateral radiograph or sagittal CT is useful as this is one of the indications for internal fixation (although operative threshold is variable) ^2,3
articular steps >1 mm are also an indication for internal fixation ²