The anterior malleolus: an unusual presentation of a pilon fracture

ABSTRACT This case report is an atypical presentation of a pilon fracture that occurred in the coronal plane and involved the anterolateral aspect of the distal tibial articular surface. This fracture pattern is typically not seen in isolation and more commonly associated with comminution and articular impaction. The mechanism of injury was not the classic high energy, axial load and instead occurred through a lower energy, rotational mechanism. This unusual case of an “anterior malleolus” fracture is of particular interest as it was initially missed on plain ankle films resulting in a delay in diagnosis and treatment.