The fibular fracture may be found 1-2cm (0.5-1 inch) above the ankle joint level, or anywhere higher, including all of the way up to just below the knee. Typically, when the fibular (bone on the outside of the ankle) fracture occurs above the ankle joint level, there is an associated syndesmosis injury. Since ligaments (and the syndesmosis) cannot be directly visualized on radiographs (plain x-ray films), it is fortunate that we can reliably predict when there has been a syndesmosis injury in conjunction with the fracture(s). Thus, in an ankle fracture with an unstable syndesmosis, surgery is typically recommended. Because of a disrupted, unstable syndesmosis, the tibia and fibula are not held together properly, which makes for a very unstable ankle joint that is prone to chronic disability and arthritis – if not repaired. In some fractures, the ligament structures (called the syndesmosis) that hold together the two leg bones (the tibia and the fibula) that form the ankle socket are torn. Perhaps the most important “classification” of ankle fracture to both the doctor and the patient is whether the fracture will need surgical correction or not. Ankle fractures can be classified by the mechanism that caused that fracture, or the number of locations that have fractured, or by the location of the fracture of the fibula (the bone on the outside of the ankle) relative to the ankle joint line. ![]() There are many varieties of ankle fracture that can occur.
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