17 August 2022 at 12:08:10
screen for medial ankle pain / Maisonneuve injury (weight bearing AP and lateral ankle x rays).
If negative --> weight bear as tolerated, crutches if needed.
If positive --> refer to Ortho oncall
On-line referral to VFC if isolated injury.
Refer to Ortho oncall if suspected Maisonneuve injury
Proximal and mid shaft fibular fractures
A proximal fibular shaft fracture may appear to an isolated fracture on a knee x ray. However, it is important to assess for an ankle medial malleolus fracture (or deltoid ligament injury) as this represents a Maisonneuve fracture, which requires surgical treatment. A weight-bearing XR of the ankle will be able to demonstrate fractures or instability within the ankle mortise.
Fibular head fracture
These fractures are uncommon, but may represent a twisting injury of the knee associated with ACL, PCL or posterolateral corner injuries. These should be managed as suspected "meniscal / ligament injuries".
