Isolated fracture of the lateral malleolus

Isolated fractures of the lateral malleolus are stable only if no other ligaments are torn. These fractures are unstable if accompanied by a tear of the deltoid or anterior tibiofibular ligament and it may be necessary to demonstrate the resulting talar instability by stress radiographs. Stable fractures are best treated by the application of a short-leg walking cast. In unstable fractures an attempt should be made to anatomically reduce the lateral malleolus by closed means followed by the application of a long-leg cast. Should subsequent loss of position occur or should it not be possible to obtain an anatomical reduction, then open reduction and internal fixation is indicated.