Trimalleolar fracture

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Ankle pain and swelling post fall.

Patient Data

Age: 60 years
Gender: Male
x-ray

Oblique fracture of the fibular shaft 6 cm above the ankle joint. Widening of the tibial syndesmosis. Widening of the medial clear space with an avulsion fracture at the medial malleolus involving the deltoid ligament. Posterior malleolus fracture.

Ankle joint effusion. Soft tissue swelling over both malleoli.

Case Discussion

An example of a Lauge-Hansen pronation external rotation (PER) stage IV injury. 

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