Background Ankle fractures caused by violence in the anterior-posterior horizontal direction are very rare in clinical practice. Few literatures report on the characteristics and mechanisms of this type of fracture, which should be studied to guide clinical treatment. Case presentation We presented two cases of ankle fractures caused by horizontal violence in the anterior-posterior direction, and these fractures presented a distinctive morphological pattern. After injury, the affected limbs showed significant swelling, and case 2 had developed osteofascial compartment syndrome, and immediate reduction and incision decompression had been performed. After the soft tissue swelling subsided, an open reduction and internal fixation surgery was performed. We fixed the tibial fractures first and then the fibular fractures, and fixed tibial fractures in anterior and medial biplane, which achieved good clinical efficacy. Conclusion Ankle joint fracture caused by horizontal force in the anterior-posterior direction may be a flexion/extension injury, which is rare and unstable and needs further research on the mechanism of injury. This type of ankle fracture may be accompanied by osteofascial compartment syndrome, which needs careful examination and timely treatment.
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Dou et al. (2026) studied this question.
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