[Risk of nerve damage by surgery of the lateral malleolus]

Fracture of the lateral malleolus is a common injury, which often requires surgery. The lateral approach is often used with a "cut straight to bone" method. In this 59-year-old woman with an ankle fracture we found a variant of the superficial peroneal nerve (SPN) crossing the operative field with great danger of laceration. A review of the literature reveals that in more than 10% of the cases significant nerve branches may be found in the operative field. This report emphasises the need for neurological exam and recommends that great care for nerve variants should be taken during surgery on and around the lateral malleolus.