Unimalleolar Ankle Fracture: Lateral Malleolus Only/Supination External Rotation (SER) 4

Abstract

A 64-year-old female with well-controlled type II diabetes sustained an injury to her right ankle when she slipped and fell on ice. She noted immediate right ankle pain and deformity, was unable to bear weight, and had diffuse swelling and ecchymosis throughout her ankle and tenderness to palpation over the lateral malleolus with no tenderness medially. Radiographs showed a long oblique lateral malleolus fracture at the level of the syndesmosis with a comminuted posterior malleolus fracture involving less than 10% of the articular surface and an incongruent tibiotalar joint with lateral subluxation of the talus seen on the mortise view. She was diagnosed with a Lauge-Hansen supination external rotation IV ankle fracture (SER IV) and underwent open reduction and internal fixation of this injury using lag-screw fixation and neutralization plating of the fibula with placement of a syndesmotic screw.