Zhang Y, et al. - For a distal tibial spiral fracture combined with a non-displaced posterior malleolar fragment (PMF), authors presumed that the treating surgeon could assess the size of the PMF to determine the need for stabilizing that structure first before rodding the tibia. Findings suggested that the height of the PMF could be used as a reliable reference predicting the risk of PMF secondary displacement caused by the distal anteroposterior locking screw when the distal tibial physeal scare was set as the limit of nail insertion depth.