Presentation
History of pain and swelling at the right ankle since one hour after a direct trauma by a heavy steel object at work, on examination: there is swelling hotness and deformity at the right ankle mainly on medial side.
Patient Data



X-ray shows displaced comminuted fracture at the distal third of the right fibula.
Fracture at the medial malleolus.
Suspected fracture at the distal tibial lateral aspect which appeared overlapped the distal fibula.
Soft tissue swelling is noted.
Case Discussion
The distal fibula appeared higher than normal suggesting distal tibiofibular syndesmosis injury.
This type of ankle fracture mostly needs ORIF.
Maisonneuve fractures may be found in this type of injury, so a radiograph of the proximal fibula is advised.