Presentation
Fall of a heavy object onto the left leg and ankle 1 hour ago. Abrasion of left lower leg (front side) and swelling around the ankle.
Patient Data
Fractures of both malleoli.
Mild soft tissue swelling.
A previous healed fracture is noted on the distal third of the fibula.
The tibiofibular clear space is 3.3 mm, the normal <6 mm.
The tibiofibular overlap is 3.6 mm, and the normal is ≥6 mm.
The medial clear space is 5.1 mm, the normal <5 mm.
Suspected injury of the distal tibiofibular ligament.
Case Discussion
These kind of fractures make the ankle unstable, so surgical treatment is often recommended.
Treatment is based on the alignment of the bones and the stability of the ankle joint.
The goal of treatment is to have the bones heal as closely to perfect as possible.
A malalignment of as little as two millimeters in the ankle joint can lead to arthritis.
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