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The Journal of Bone and Joint Surgery, Vol 69, Issue 3 381-384, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc

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The relationship between oblique fractures of the medial malleolus and concomitant fractures of the anterolateral aspect of the tibial plafond

AA Giachino and DI Hammond

Considerable disagreement exists concerning the mechanism by which the relatively uncommon oblique fracture of the medial malleolus is produced, and to our knowledge the relationship between it and a fracture of the anterolateral aspect of the tibial plafond has not previously been recognized. We treated a patient with these fractures whose deformed steel-reinforced work boot indicated that the mechanism of injury had been external rotation, dorsiflexion, and abduction. We found this fracture pattern in eleven other patients. We concluded that the malleolar fracture is an oblique avulsion injury and that impingement of the talus on the anterolateral aspect of the tibial plafond accounts for the other fracture. The identification of an oblique medial malleolar fracture should prompt a search for a fracture of the anterolateral aspect of the tibial plafond; the reverse is also true.
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