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Proximal fibular fracture (arcuate sign)

Case contributed by Haytham Bedier
Diagnosis almost certain

Presentation

Trauma to the left aspect of the knee. Then developed pain and difficulty walking.

Patient Data

Age: 20 years
Gender: Male

Small avulsion fracture of the styloid process of the proximal fibula, with a defect in the fibular head noted. The lateral aspect of the fibular head shows a cortical discontinuity and small transverse fracture line.

Case Discussion

The avulsed triangular-shaped fracture fragment in this case demonstrates the arcuate sign which indicates arcuate ligament-complex injury. The small transverse fracture line seen at the lateral aspect of fibular head raises suspicion for fibular collateral ligament incompetence.

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