Presentation
Ankle sprain while playing football (soccer).
Patient Data
Radiographs revealed a trimalleolar ankle fracture. There is a lateral malleolar fracture at the level of the syndesmosis, in keeping with a Weber type B lateral malleolus fracture. There is also a medial malleolar fracture, and a discrete posterior malleolar fracture is noticed on the lateral view.
Case Discussion
Trimalleolar ankle fractures have usually been reported as having poorer outcomes than bimalleolar fractures 1.
The management of these fractures mostly follows the same principles as bimalleolar fractures, but the fixation of the posterior malleolus is still a topic of debate amongst many orthopedic surgeons 2.
Radiographic evaluation of the posterior malleolus fragment may either under- or overestimate its size, proper assessment can be performed by a CT study 2.