Kostlivý K, et al. - Given the linking of posterior malleolar fractures (PM) to inferior outcome in malleolar fractures, researchers examined the prevalence and pathoanatomy of PM fractures in Bosworth fracture-dislocations (BF). They evaluated the pathoanatomy of BF via assessing radiographs and computed tomography scans of 13 patients treated at their institution and 97 cases published between 1947 and 2018, identified in a systematic literature search. They identified a posterior malleolar fracture in all 13 patients (100%) with Bosworth fracture-dislocations from the present series and 61 of 97 documented cases (63%) from the literature. Findings suggest a possibly higher true prevalence because of the historically infrequent use of computed tomography imaging. They observed extraincisural (Bartonicek/Rammelt type 1) posterior malleolar fractures in correlation to the dislocation of the fibula behind the posterior tibial rim. Bartonicek/Rammelt types 2 and 3 posterior malleolar fractures were evident in correlation with the displacement of the fibula between the displaced posterior tibial fragment and the tibia. They recommend performing computed tomography scanning routinely in Bosworth fracture-dislocations to discover the pathoanatomy of associated posterior malleolar fractures and the surgical approach.