Presentation
The patient tripped and fell. Presents with lateral malleolar pain and swelling and is unable to weight bear.
Patient Data
There is an avulsion fracture injury of the lateral malleolar tip with soft tissue swelling. There is anterior and mild posterior soft tissue swelling additionally.
Case Discussion
Features suggestive of an avulsion fracture injury of the lateral malleolar tip. This would be consistent with a calcaneofibular ligament injury and likely associated with an anterior talofibular ligament injury too.
An os subfibulare must always be considered and excluded. In this instance, the patient is symptomatic with lateral soft tissue swelling. In addition, the fragment is ill-defined and poorly corticated at the avulsed surface and an avulsion fracture rather than an accessory ossicle is suspected.
Confirmatory ultrasound and/or MRI was recommended.
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