Presentation
The patient came with a complaint of pain and swelling over the right ankle for 2 hours with a history of twisting while playing football.
Patient Data
Age: 30 years
Gender: Male
From the case:
Medial malleolus fracture
{"study":{"id":123183,"case_slug":"medial-malleolus-fracture-4","modality":"X-ray","series":[{"id":58954401,"content_type":"image/png","frames":[{"id":58954401,"width":552,"height":859,"current":true}],"annotations":[],"encodings":{"original_dicom":null,"video":null,"thumbnailed_files":[{"tiny":"3b5fe4cd7ab5769edf06c3b08c066340df6cf1291f37695480381ff4f95c3054_tiny.jpeg","jumbo":"3b5fe4cd7ab5769edf06c3b08c066340df6cf1291f37695480381ff4f95c3054_jumbo.jpeg","small":"3b5fe4cd7ab5769edf06c3b08c066340df6cf1291f37695480381ff4f95c3054_small.jpeg","thumb":"3b5fe4cd7ab5769edf06c3b08c066340df6cf1291f37695480381ff4f95c3054_thumb.jpeg","medium":"3b5fe4cd7ab5769edf06c3b08c066340df6cf1291f37695480381ff4f95c3054_medium.jpeg","gallery":"3b5fe4cd7ab5769edf06c3b08c066340df6cf1291f37695480381ff4f95c3054_gallery.jpeg","big_gallery":"3b5fe4cd7ab5769edf06c3b08c066340df6cf1291f37695480381ff4f95c3054_big_gallery.jpeg","original":"3b5fe4cd7ab5769edf06c3b08c066340df6cf1291f37695480381ff4f95c3054.png"}]},"perspective":"Frontal","specifics":""},{"id":58954402,"content_type":"image/png","frames":[{"id":58954402,"width":776,"height":843,"current":true}],"annotations":[],"encodings":{"original_dicom":null,"video":null,"thumbnailed_files":[{"tiny":"92e28e6c2bb07a0c4d1b05b67b44c68854e35d271d8f287a844ad8c391f966b9_tiny.jpeg","jumbo":"92e28e6c2bb07a0c4d1b05b67b44c68854e35d271d8f287a844ad8c391f966b9_jumbo.jpeg","small":"92e28e6c2bb07a0c4d1b05b67b44c68854e35d271d8f287a844ad8c391f966b9_small.jpeg","thumb":"92e28e6c2bb07a0c4d1b05b67b44c68854e35d271d8f287a844ad8c391f966b9_thumb.jpeg","medium":"92e28e6c2bb07a0c4d1b05b67b44c68854e35d271d8f287a844ad8c391f966b9_medium.jpeg","gallery":"92e28e6c2bb07a0c4d1b05b67b44c68854e35d271d8f287a844ad8c391f966b9_gallery.jpeg","big_gallery":"92e28e6c2bb07a0c4d1b05b67b44c68854e35d271d8f287a844ad8c391f966b9_big_gallery.jpeg","original":"92e28e6c2bb07a0c4d1b05b67b44c68854e35d271d8f287a844ad8c391f966b9.png"}]},"perspective":"Lateral","specifics":""}],"caption":{"us":null,"gb":null},"findings":{"us":"","gb":""},"contributor_login":"drc","case_id":147962,"case_key_image_id":null,"case_featured_at":null},"current_user":null,"access":{"can_edit":false,"can_download":true,"can_feature":false,"can_pin":true}}
The x-ray shows an avulsed fracture at the tip of the medial malleolus. Soft tissue swelling is also noted around the ankle joint.
From the case:
Medial malleolus fracture
{"study":{"id":123184,"case_slug":"medial-malleolus-fracture-4","modality":"Annotated image","series":[{"id":58954406,"content_type":"image/png","frames":[{"id":58954406,"width":777,"height":870,"current":true}],"annotations":[],"encodings":{"original_dicom":null,"video":null,"thumbnailed_files":[{"tiny":"7419aa62ffc4ed5985989c84bfb0ed6b29307453c611e04d9c437b0cffef857a_tiny.jpeg","jumbo":"7419aa62ffc4ed5985989c84bfb0ed6b29307453c611e04d9c437b0cffef857a_jumbo.jpeg","small":"7419aa62ffc4ed5985989c84bfb0ed6b29307453c611e04d9c437b0cffef857a_small.jpeg","thumb":"7419aa62ffc4ed5985989c84bfb0ed6b29307453c611e04d9c437b0cffef857a_thumb.jpeg","medium":"7419aa62ffc4ed5985989c84bfb0ed6b29307453c611e04d9c437b0cffef857a_medium.jpeg","gallery":"7419aa62ffc4ed5985989c84bfb0ed6b29307453c611e04d9c437b0cffef857a_gallery.jpeg","big_gallery":"7419aa62ffc4ed5985989c84bfb0ed6b29307453c611e04d9c437b0cffef857a_big_gallery.jpeg","original":"7419aa62ffc4ed5985989c84bfb0ed6b29307453c611e04d9c437b0cffef857a.png"}]},"perspective":"Magnified frontal","specifics":null}],"caption":{"us":null,"gb":null},"findings":{"us":"","gb":""},"contributor_login":"drc","case_id":147962,"case_key_image_id":null,"case_featured_at":null},"current_user":null,"access":{"can_edit":false,"can_download":true,"can_feature":false,"can_pin":true}}
This annotated zoom view shows the avulsed fracture at the tip of the medial malleolus (yellow arrow).
Case Discussion
Often, such ankle fractures will be treated conservatively by immobilization with a plastic splint.