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Woman with Severe Ankle Pain After Fall

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There is an obvious oblique fracture of the distal fibula.  In addition, there is widening of the mortise medially—usually suggestive of a ligament injury. Also, there may be a small avulsion at the inferior aspect of the medial malleolus.

The patient was admitted with a plan for her to undergo an open reduction and internal fixation procedure.

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Nandan Hichkad, PA-C, MMSc

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Clinician Reviews - 21(2)
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ankle pain, pain, fall, severe pain, swollen, bruising, limited, flexion, extension, fracture, distal fibula, mortise, ligament, avulsion
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Nandan Hichkad, PA-C, MMSc

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Nandan Hichkad, PA-C, MMSc

ANSWER
There is an obvious oblique fracture of the distal fibula.  In addition, there is widening of the mortise medially—usually suggestive of a ligament injury. Also, there may be a small avulsion at the inferior aspect of the medial malleolus.

The patient was admitted with a plan for her to undergo an open reduction and internal fixation procedure.

ANSWER
There is an obvious oblique fracture of the distal fibula.  In addition, there is widening of the mortise medially—usually suggestive of a ligament injury. Also, there may be a small avulsion at the inferior aspect of the medial malleolus.

The patient was admitted with a plan for her to undergo an open reduction and internal fixation procedure.

Issue
Clinician Reviews - 21(2)
Issue
Clinician Reviews - 21(2)
Publications
Publications
Topics
Article Type
Display Headline
Woman with Severe Ankle Pain After Fall
Display Headline
Woman with Severe Ankle Pain After Fall
Legacy Keywords
ankle pain, pain, fall, severe pain, swollen, bruising, limited, flexion, extension, fracture, distal fibula, mortise, ligament, avulsion
Legacy Keywords
ankle pain, pain, fall, severe pain, swollen, bruising, limited, flexion, extension, fracture, distal fibula, mortise, ligament, avulsion
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A 39-year-old woman presents to your emergency department complaining of right ankle pain following an injury last night. She states that she got out of bed during the night, somehow misstepped, and fell to the floor. She is unable to bear weight on the ankle and is experiencing severe pain. Her medical history is significant for being one month status post Chiari decompression. She also has a history of bipolar disorder. Examination of the patient’s right ankle shows it to be moderately swollen with some bruising laterally. The patient has limited flexion and extension, and her ankle is extremely tender to palpation. Her distal pulses and her sensation are intact. Radiographs of the right ankle are shown. What is your impression?
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