Presentation
Ankle pain following trauma.
Patient Data
Limited views of the tibia/fibula and ankle show widening of the medial and tibiofibular clear spaces and a spiral fracture of the proximal fibula.
Case Discussion
Widening of the medial clear space indicates a tear of the deltoid ligament while widening of the tibiofibular clear space indicates a tear of the distal tibiofibular syndesmosis. This combination of ligamentous injuries is often associated with a fibular fracture and if no fracture is present on an ankle series, the entire fibula should be imaged. The combination of a deltoid ligament tear (or its bony equivalent, avulsion of the medial malleolus), disruption of the ankle syndesmosis and a proximal fibular fracture is know as a Maisonneuve fracture.
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