This one is interesting. The Xray that follows shows displaced fracture of fibula with subluxation of ankle joint. On left is anteroposterior view and on right is lateral view.

This patient suffered injury after he tried to get down from moving bus. His ankle got twisted and that resulted in injury. He was taken to the hospital where he was evaluated and a splint was applied. The shadow of splint is visible in Xray.

Anteroposterior View
This is view on the left side and shows a fracture in fibula (upper arrow) and subluxation of ankle which is depicted by increased joint space in the ankle (lower arrow). There is no fracture of medial malleolus visible.

Lateral View
This is on right side and shows fracture fibula (upper arrow). Joint space cannot be commented upon because the xray does not show it.
But there appears a fracture of cuboid in the foot (lower arrow). This fracture is not visible in the other view because of overlapping shadows of other bones of foot. We need anteroposterior view of the foot to ascertain that.

Author’s Notes

This injury has resulted from twisting force to ankle. In such cases of injury, the usual result is bimalleolar fracture i.e. Fibula as well as medial malleolus are fractured. However in fewer cases, the deltoid ligament ( Ligament that connects tibia to talus bone on the foot. This ligament is quite important in maintaining stability of the ankle joint.) breaks earlier and medial malleolus is spared.

Because the injury is to lateral as well as medial structures, this has resulted in instability of ankle joint, which is visible as subluxation.

Fracture of the cuboid bone might have resulted from the impact of the foot on the ground.

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Related posts:

1. Xray of Malunited Fracture of Tibia and Fibula With Varus Angulation
2. Xrays of Bimalleaolar Fracture With Ankle Dislocation
3. Xray of Fracture of Lateral Malleolus
4. Xray of Fracture of Medial Malleolus of Tibia
5. Segmental Fracture Fibula With Fracture Tibia – Anteroposterior Xray