43t-E/7.1   Avulsion fractures of the medial malleolus

This fracture type involves avulsion of the medial malleolus and is classified as 43t-E/7.1.

An associated distal fibular fracture may have a different configuration, may not involve the epiphysis, and is classified separately.

This injury may be part of a more complex unstable ankle injury with a fibular fracture and syndesmotic disruption.

These fractures are uncommon and more frequent in older children and adolescents. They are usually caused by an eversion force.

Avulsion fractures are usually diagnosed with x-rays.

If in doubt, compare to the contralateral leg x-ray to determine normal ossification centers, which may mimic a fracture.

X-rays showing an avulsion of the medial malleolus in a 7-year-old patient