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Distal tibial and fibular fractures

Case contributed by Derek Smith
Diagnosis certain

Presentation

Fall from ladder. Tender weightbearing and lateral malleolus.

Patient Data

Age: 55 years
Gender: Male

Subtle distal tibial fracture, best demonstrated on the oblique view.

Trabecular disruption of the distal fibula.

Lateral talar shift demonstrated.

Plate and screw fixation.

Good opposition of the fractures and relocation of the talus.

Case Discussion

With the pattern of injury, mainly of the lateral tibia (which is unusual), medial mortise widening, and subtle transverse fracture through the distal fibula, this injury was probably sustained in a supination-external rotation injury, which is the commonest mechanism of ankle fracture.

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