Trimalleolar ankle fracture

Case contributed by Mohammad Osama Hussein Yonso


History of injury to right ankle and right leg due to fall at work place, today, local examination: no open wound, tenders on right ankle and lower leg.

Patient Data

Age: 40 years
Gender: Male

Non-displaced fracture at the right medial malleolus.

Posterior malleolus fracture is noted with no significant displacement. 

Non-displaced fracture at the lower third of the shaft of the right fibula. 

Soft tissue shadows appear swollen.

Small calcaneal spurs.

Case Discussion

This is a simple non-displaced suprasyndesmotic fracture associated with an incomplete appearing medial malleolus fracture and a Volkmann (or posterior malleolus) fracture.

According to the AO/OTA classification this 44C1.3 or Weber C

According to Lauge Hansen, this is probably a pronation-exorotation injury Stage 4.

The treatment can be with immobilization in a plastic splint for 8 weeks.

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