Presentation
Left ankle injury causing pain while walking.
Patient Data
Small effusion in the anterior ankle joint recess. Fractures involving both tibial as well as fibular attachment sites of the anterior inferior tibiofibular ligament (AITFL). The tibial fracture is an avulsion type. The fibular fracture extends proximally and laterally. The ligament itself is intact.
Normal anterior talofibular ligament and the calcaneofibular ligament. No avulsion injury to the calcaneal anterior process.
For comparison, the contralateral (right) side anterior tibiofibular ligament (AITFL) was examined. Normal ligament without avulsion.
Cine-loop runs from the proximal to the distal direction. It's obliquely oriented as shown in the body pattern in the loop.
The drawing represents the type of injury. Avulsion fracture of the tibia at the anterior inferior tibiofibular ligament attachment site. Single oblique fracture of the distal fibula without fibular avulsion. The ligament is attached to the proximal fibular fragment.
Case Discussion
The patient had an ankle injury three weeks before the ultrasound. Initial AP and lateral radiographs were negative (not uploaded, no copyright). The pain persisted after the initial few days of immobilization. The ultrasound was requested for ankle ligaments.
The case shows a Tillaux-Chaput tubercle fracture with an associated transsyndesmotic distal fibular fracture.
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