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Fractures through the distal weight-bearing surface of the tibia.

Fractures of the distal tibial plafond have been associated with an usually high incidence of morbidity and both early and late complications. Fractures through the distal tibial plafond can be divided into three basic groups: (1) distal tibial compression fractures; (2) external rotatory trimalleolar fractures with large posterior fragments; and (3) spiral extension fractures. Loss of length and alignment at the ankle joints, with concomitant loss of congruity of the articular surface, requires innovative intervention to prevent disability. The prognosis for these fractures depends not only on the amount of articular involvement of the ankle joint, but also on the accuracy of the reduction and the details of postoperative care.