The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
October 13, 2026 · via Europe PMC
Impact of CT-Based Posterior Malleolar Fracture Classifications on Clinical Outcomes in Bimalleolar Ankle Fractures Involving the Posterior and Lateral Malleoli.
Çaltepe S, Güler M, Ceylan A, Çakır MB, Alp MB, Polat A.
AI summary — for doctors, generated from the abstract only
Three CT-based posterior malleolar fracture classifications did not show significant associations with 1-year outcomes in uniformly treated bimalleolar fractures.
What was studied
A retrospective cohort of 58 patients with posterior malleolar and Weber B lateral malleolar fractures fixed through a posterolateral approach, comparing Haraguchi, Bartonicek/Rammelt and Mason-Molloy subgroups on 1-year AOFAS score and Kellgren-Lawrence grade.
Key findings
- Mean AOFAS score was 92.97 ± 5.28; 10 patients (17%) scored 100 and 24 (41%) scored 95 or more
- Subgroup AOFAS did not differ for Haraguchi (p = 0.994), Bartonicek/Rammelt (p = 0.130) or Mason-Molloy (p = 0.836)
- AOFAS did not correlate with fragment lengths (rho = 0.001 and 0.049)
Clinical relevance
Suggests the classification type may not predict outcomes when fractures are fixed through the same approach, though this cannot be treated as proof of no effect.
Who should care
Limitations
Small, uneven subgroups and ceiling clustering of AOFAS limit statistical power; the authors say meaningful associations cannot be excluded. Retrospective and one-year follow-up.
No significant link between classification and outcome was detected, but the study was underpowered.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
The prognostic value of computed tomography (CT)-based posterior malleolar fracture classifications in uniformly treated fractures remains uncertain.
Purpose
To examine associations of the Haraguchi, Bartoníček/Rammelt, and Mason-Molloy classifications with 1-year functional and early radiographic outcomes.
Study design
Retrospective cohort study.
Methods
Fifty-eight patients with posterior malleolar and Weber B lateral malleolar fractures underwent fixation of both malleoli through a posterolateral approach. Outcomes were the 1-year American Orthopaedic Foot & Ankle Society (AOFAS) score and Kellgren-Lawrence grade. Classification subgroups were compared using Kruskal-Wallis tests; fragment dimensions were assessed using Spearman correlations.
Results
Mean AOFAS score was 92.97 ± 5.28 (95% confidence interval [CI], 91.58-94.35); 10 patients (17%) scored 100 and 24 (41%) scored ≥ 95. Subgroup mean scores were 91.0-93.3 for Haraguchi (p = 0.994), 84.0-96.5 for Bartoníček/Rammelt (p = 0.130), and 87.0-93.3 for Mason-Molloy (p = 0.836). Kellgren-Lawrence grades did not differ across Haraguchi, Bartoníček/Rammelt, or Mason-Molloy subgroups (p = 0.449, p = 0.277, and p = 0.608, respectively). AOFAS correlations with axial and sagittal fragment lengths were ρ = 0.001 (95% CI, -0.273 to 0.285; p = 0.992) and ρ = 0.049 (95% CI, -0.242 to 0.342; p = 0.717), respectively.
Conclusions
No significant associations with 1-year outcomes were detected. Small, uneven subgroups and upper-end AOFAS clustering limited precision; potentially meaningful prognostic associations cannot be excluded.
DOI
10.1053/j.jfas.2026.10.010
PMID
42869172
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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