Trimalleolar ankle fracture

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

Rollerskating, plantar flexed injury.

Patient Data

Age: 25-year-old

Right ankle radiographs

x-ray

Ankle trimalleolar fracture. 

CT Right Ankle

ct

Oblique fracture through the distal fibular metaphysis extending into the ankle joint. Distal tibiofibular articulation is not widened. Fracture through the medial tibial malleolus associated with tiny bone loose bodies. Comminuted fracture involving the posterior aspect of the distal tibial plafond, also with intraarticular extension. No other fractures seen within the mid and hindfoot. Small sclerotic foci within the talus and medial cuneiform bones are consistent with enostoses. Soft tissue swelling around the ankle joint.

Case Discussion

Trimalleolar fracture refers to a three-part fracture of the ankle: medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus.

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