Presentation
Fall from 4 meters.
Patient Data
Markedly comminuted displaced fracture of the right distal fibula. Further comminuted fracture of the distal tibial plafond as well as the medial malleolus. The medial tibial at the level of the ankle joint protrudes into a large soft tissue laceration consistent with a compound injury.
Comminuted fractures of the lateral process of the talus with fracture line extending into the sinus tarsi.
No calcaneal or other tarsal fracture identified.
Extensive soft tissue stranding, and multiple locules of gas within the ankle joint as well as surrounding soft tissues consistent with a compound injury.
There is also markedly abnormal ankle joint alignment with approximately 13 mm lateral talar shift.
Case Discussion
This case shows multiple ankle comminuted fractures characterizing a trimalleolar fracture, which refers to a three-part fracture of the ankle. The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus.
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