A 60 year old female visited the ED after a mechanical fall. She tripped and fell from standing. No significant past medical history. What is the diagnosis ?
Trimalleolar fracture with dislocation
Trimalleolar fractures are unstable fractures and require surgical intervention.
Initial diagnosis is usually made by xrays. However, xrays alone can miss some lesions like posterior malleolar lesions, loose bodies or lesions around the syndesmosis.
It is recommended to get a CT scan of the ankle to look for those subtle lesions. Obtaining CT scan images often change the operative managment plan for those cases.
Leung, Ka Hei, et al. "Preoperative radiography versus computed tomography for surgical planning for ankle fractures." Journal of Orthopaedic Surgery 24.2 (2016).
