case_images: PMC11723718_01
case_images: Pre-operative X-rays indicate subcutaneous gas without fracture or lateral ankle dislocation (A and B).
case_images: JOCR-15-94-g001.jpg
case_images: PMC11723718_01_JOCR-15-94-g001.jpg
case_images: F1
case_images: The ankle mortise was well preserved on initial imaging (Fig. 1).
case_images: Intraoperative films indicative of ATFL and calcaneofibular ligamentous injury. Intra-operative films show initial mortise view (A) with negative external rotation stress view (B). Stress views reveal positive varus stress (C) and a positive anterior drawer (D). The mortise view displays a negative varus stress test (E) and the final lateral view shows a negative anterior drawer test (F).
case_images: JOCR-15-94-g002.jpg
case_images: PMC11723718_01_JOCR-15-94-g002.jpg
case_images: F2
case_images: Once exposure was completed, stress examinations were performed showing a negative external rotation stress test but a positive anterior drawer and a positive varus stress test (Fig. 2).
case_images: Open lateral dislocation with ligamentous injury can be treated utilizing a suture anchor. Injury to the ATFL and calcaneofibular ligaments was noted without associated osseous injury (A). Augmentation of primary repair was made with a suture anchor (B).
case_images: JOCR-15-94-g003.jpg
case_images: PMC11723718_01_JOCR-15-94-g003.jpg
case_images: F3
case_images: The other suture was used to further reinforce the repair (Fig. 3).
case_images: Post-operative films show successful operative fixation. Six-month post-operative films show stable hardware with no evidence of syndesmotic widening or osseous abnormalities (a and b).
case_images: JOCR-15-94-g004.jpg
case_images: PMC11723718_01_JOCR-15-94-g004.jpg
case_images: F4
case_images: Radiographs showed maintenance of ankle alignment with no radiographic or clinical signs of instability (Fig. 4).