Isolated Lateral Malleolus Fracture

  • Scott J. Schoenleber
Living reference work entry


Fractures of the lateral malleolus in the skeletally immature patient are relatively common. Although in many cases these are associated with fractures of the distal tibia, the distal fibula may be fractured in isolation. In the majority of these, the fracture is non-displaced and diagnosed on the basis of soft tissue swelling and tenderness at the level of the distal fibular physis. Additionally, displaced Salter-Harris types I and II patterns may be seen. These occur most commonly in patients between the ages of 10 and 12 years. The mechanism of injury is typically due to supination-inversion. Treatment of non-displaced fractures may be safely performed either with a short leg walking cast or a brace, depending on surgeon and patient preference. Displaced fractures should be reduced and immobilized in a non-weightbearing cast for 4–6 weeks. While growth arrest and shortening have both been reported in a small number of patients with type I fractures, complications with type II fractures remain rare.

References and Suggested Reading

  1. Podeszwa DA, Mubarak SJ (2012) Physeal fractures of the distal tibia and fibula (Salter-Harris type I, II, II, and IV fractures). J Pediatr Orthop 32:S62–S68CrossRefPubMedGoogle Scholar
  2. Sankar WN, Chen J, Kay RM, Skaggs DL (2008) Incidence of occult fracture in children with acute ankle injuries. J Pediatr Orthop 28:500501CrossRefPubMedGoogle Scholar
  3. Spiegel PG, Cooperman DR, Laros GS (1978) Epiphyseal fractures of the distal ends of the tibia and fibula. J Bone Joint Surg (Am) 60-A:10461050CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryNicklaus Children’s HospitalMiamiUSA

Section editors and affiliations

  • L. Reid Nichols
    • 1
  1. 1.Nemours/Alfred I. duPont Hospital for ChildrenWilmingtonUSA

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