Incidence of Midfoot Instability Associated With Medial Malleolus Fractures: A Retrospective Cohort Study

Ankle fractures with medial malleolus fractures have a significantly higher incidence of medial arch instability. Rotational ankle injuries, arising from supination external rotation and pronation injuries, can significantly affect medial arch stability. We advocate that surgical restoration of superficial deltoid-spring/capsular-ligamentous integrity and/or early post-operative orthotics after medial malleolar fractures may protect the first ray destabilization and preserve future foot function.