Fibula and lateral malleolus

[Apollyon]

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OK, call me dumb, but I'm still (as an EM attending) confused just a bit. On one side, I've been taught that there is no purpose for the fibula, save for an insertion for the plantaris muscle (which in itself has no purpose except to hurt when it ruptures and to contribute for tendon transplants), but, at the same time, the distal fibula is the lateral malleolus, and I thought that the ankle would become unstable without the lat and/or med malleoli.

Can someone educate me?

 

[Blesbok]

OK, call me dumb, but I'm still (as an EM attending) confused just a bit. On one side, I've been taught that there is no purpose for the fibula, save for an insertion for the plantaris muscle (which in itself has no purpose except to hurt when it ruptures and to contribute for tendon transplants), but, at the same time, the distal fibula is the lateral malleolus, and I thought that the ankle would become unstable without the lat and/or med malleoli.

Can someone educate me?

http://www.wheelessonline.com/ortho/ao_weber_type_a_malleolar_fractures

Read about weber types a,b, and c. The fibula is very much involved with ankle stability. It has a lot of ligamentous attachment. However, long term a lot of the concern in deciding how to fix it has to do with damage to the syndesmosis depending on the level and method of injury.

 

[Apollyon]

Oh duh - didn't even think to look at Wheeless. (I'm red-faced to tell you I did my EM at Duke!)

Thank you for your response!

 

[Buckeye(OH)]

What you said is true, at my institution, we generally fix isolated lateral mal fx. As you mentioned, they are the cornerstone to preventing excessive external rotation.