In these fractures, the articular surface exhibits an impacted area of articular surface in addition to the simple fracture line. In this area the fragments remain in contact like the tiles of a mosaic. They can be divided as:
Frontal/coronal plane fractures (classified by AO/OTA as 43B2.1)
Sagittal plane fractures (classified by AO/OTA as 43B2.2)
Central fragment fracture (classified by AO/OTA as 43B2.3)
Standard AP and lateral x-rays are taken. More detailed information is provided by CT-scans with 2-D and 3-D reconstructions.
Clinical assessment must include the condition of the soft tissues as well as the sensory and motor function of the foot structures. Special attention is given to any signs of a compartment syndrome. Standard AP and lateral x-rays are taken. In case of doubt, CT-scans may be helpful to detect or exclude involvement of the articular surface. For all distal tibia fractures, the fibula must be classified as intact, or fractured into two or multiple fragments.