ATFL Avulsion Fractures
- The most common type of ATFL injury is a pure ligamentous rupture, followed by an avulsion fracture from the tip of the lateral malleolus.
- Avulsion fractures from the talus are rare after lateral ankle sprains.
Difficulty in Differentiating Os Subfibulare and Fibular Avulsion Fractures
- Os subfibulare and ATFL fibular avulsion fractures, especially in chronic cases, are challenging to differentiate radiologically.
Differential Diagnosis: Avulsion Fractures of the Distal Fibula
- Avulsion fractures of the distal fibula are typically caused by inversion injuries of the ankle.
- Clinical signs include swelling, effusion, pain, and instability, which helps confirm avulsion fractures and rule out os subfibulare.
- Avulsion fractures are more common in older patients and usually involve the insertion site of the anterior talofibular ligament.
- Rounded margins on radiographs often complicate differentiation between avulsion fractures and os subfibulare.
Significantly Displaced Fragments
- In some cases, significantly displaced fragments make it difficult to determine if they are avulsed from the lateral malleolus or the talus.
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