Posterior malleolus fractures are usually seen in conjunction with other ankle fractures, such as bimalleolar fracture, trimalleolar fracture, Maisonneuve fracture, spiral fracture of the tibial shaft, pilon fracture, etc.

Twisting injuries to the ankle, falls from heights, and car accidents are common causes of this type of fracture. Parachute landing (impaction from the talus pushing up into the posterior edge of distal tibia) is another possible cause.

This fracture is characterized by injury to the ankle followed by pain, swelling, and inability or difficulty with weight-bearing.

It is rare for a posterior malleolus fracture to occur in isolation, only accounting for approximately 1%-4% of all ankle fractures. An isolated posterior malleolus fracture is also known as a Volkmann fracture.