Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Ankle Case 2 Diagnosis

Distal fibula fracture


Diagnosis is made by standard ankle X rays. These films should be examined so not to miss a subtle associated fracture to the medial or posterior malleolus, which would indicate a more unstable injury.

The physician may be called upon to perform a stress view of the ankle to assess ankle stability:

  • This is performed by stabilizing the leg with one hand while the other hand grasps the great toe and everts the foot while an AP film is taken.
  • Widening of the medial joint space on a stress view compared to the non-stress view signifies an unstable ankle mortise (see blue circle on image).