Orthopedics
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When open reduction is indicated the lateral malleolus fracture should be reduced as accurately as the medial or posterior malleolar fragments. The cerclage for displaced oblique or spiral fractures of the lateral malleolus is a simple, effective way of internal fixation with a minimal amount of metal implanted. Under direct vision an anatomical reduction is achieved and maintained. ⋯ In a displaced bimalleolar or trimalleolar fracture, the cerclage can be used in conjunction with various other internal fixation screws or nails applied to the medial and/or posterior malleolar fragment. The exact method varies depending on the type of fracture present. With increasing recognition of the importance of anatomic reduction of the lateral malleolus in the ankle fracture management, cerclage technique will contribute further toward the restoration of the normal ankle joint mechanics.