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The objective of this study was to compare the biomechanical behavior of four fixation methods for posterior malleolar fracture (PMF) by finite element analysis (FEM). Four internal fixation techniques used for fixation of PMF were assessed by FEM - a computational study posterior one-third tubular 3.5 mm buttress plate (PP) with one screw (PP 1 screw), PP with two screws (PP 2 screws), two cannulated 3.5 mm lag screws in the antero-posterior (AP) direction (AP lag screws), and two postero-anterior (PA) cannulated 3.5 mm lag screws (PA l