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Pronation-Abduction
Hallmark:
- Short, oblique fracture of the fibula AT the level of the syndesmosis
Stage I
- Rupture of the deltoid ligament OR
- Fracture of the medial malleolous
Stage II
- Rupture of the anterior/posterior tibio-fibular ligament with possible avulsion
Stage III
- Short, oblique fracture of the fibula AT the level of the syndesmosis
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Complete syndesmosis diastasis
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Stage II has the possibility of having no fracture and is often mistaken as a high ankle sprain.
Stage II-III injuries are unstable.
Syndesmosis screw(s) is necessary.
Prefer one 4.5mm fully threaded cortical screw involving four cortices.
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Short, oblique fibular fracture
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No fracture seen
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Stress external rotation
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Syndesmosis screw
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