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Surgical Reconstruction of an Open Medial Malleolus Fracture Using a Novel Technique

A Case Report

Kow, Ren Yi MBBS1; Yuen, Jin Chuan MS Ortho(UKM)1; Ahmad Alwi, Akmal Azim MS Plastic Surgery(USM)2; Abas, Muhammad Firdaus MS Plastic Surgery(USM)1; Low, Chooi Leng MBBS(IMU)1

doi: 10.2106/JBJS.CC.18.00163
Case Reports

Case: A 17-year-old male sustained an open fracture of the right medial malleolus (MM) with significant bone and soft tissue loss following a motor-vehicle accident. Following serial wound debridement, his ankle was effectively reconstructed with MM antiglide plate stabilization, iliac autogenous bone graft, and a free radial forearm soft tissue flap.

Conclusions: Open MM fracture with bone and soft tissue loss is rare. It is feasible to treat this injury with a novel surgical reconstruction technique involving autogenous bicortical iliac bone graft and radial forearm free flap.

1Department of Orthopaedic Surgery, Hospital Tengku Ampuan Afzan, Pahang, Malaysia

2Department of Surgery, International Islamic University Malaysia, Pahang, Malaysia

E-mail address for R.Y. Kow:

Investigation performed at the Hospital Tengku Ampuan Afzan, Pahang, Malaysia

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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