A Young Man with Acute Ankle Injury

Differential Diagnosis

• Achilles tendon rupture
• Ankle dislocation
• Metatarsal fracture
• Posterior malleolar fracture
• Talar dome injury

Diagnosis
The patient sustained an isolated posterior malleolar fracture.

Learnings/What to Look for

• Typically, this injury is the result of acute foot flexion
• Relevant to imaging, the injury is often visible only on the lateral view
• This injury usually occurs in association with bimalleolar or trimalleolar fracture, but in this case is isolated

Pearls for Urgent Care Management and Considerations for Transfer

• Surgery is often required
• Postoperative care typically requires that the patient be non–weight-bearing for 6 weeks before initiating physical therapy

Acknowledgment: Image courtesy of Teleradiology Specialists.