Is Ankle Post-traumatic Osteoarthritis Inevitable after Malleolar Fractures?

The tibiotalar joint is one of the most prevalent intra-articular fracture sites in the human body, resulting in high rates of post-traumatic ankle osteoarthritis (PTOA). Studies have shown multifactorial causes for PTOA and highlight the importance of three determining factors for clinical outcomes after malleolar fracture: quality of joint reduction and fracture fixation, residual ligament instability, and initial damage to joint tissues-including chondral tissue, synovial tissue, and synovial fluid. This special article summarizes recent evidence of malleolar fractures treatment, with a main focus on important factors related to improve clinical outcomes in order to avoid post-traumatic ankle osteoarthritis (OA).