Isolated Displaced Chaput Fracture (Rammelt Type III) With Significant Intra-articular Displacement: A Case Report

The distal tibiofibular syndesmosis, which is essential for preserving ankle stability, is often involved in ankle injuries. Avulsion fractures of the anterior inferior tibiofibular ligament, also referred to as Chaput fractures, if left untreated, may go undetected on plain radiographs and result in chronic instability. For precise evaluation and treatment planning, advanced imaging techniques such as computed tomography (CT) are frequently necessary. We present the case of a 23-year-old man who fell from a height of 2 m and suffered a twisting injury to his right ankle and was seen at King Hussein Medical Hospital. A Chaput fracture was suggested on the first radiographs. A single displaced Chaput fracture with an articular step-off larger than 2 mm was discovered after additional CT assessment. An anterolateral approach to the ankle was used to access the fracture and to perform internal fixation. A progressive physiotherapy rehabilitation protocol followed his unremarkable operative fixation. The patient regained complete range of motion with no pain or functional limitations at the three-month follow-up. Ankle fractures are frequently linked to syndesmotic injuries, which can be challenging to diagnose with just plain radiographs. CT imaging enhances the identification of avulsion fragments and offers a more accurate assessment of the displacement and shape of fractures. Syndesmotic stability may be attained without further fixation by simply fixing the Chaput fragment. Chaput fractures must be accurately diagnosed and treated to restore ankle stability and avoid long-term problems. Anatomical reduction may reduce the need for extra syndesmotic fixation in certain individuals, and CT imaging is an important part of the evaluation process.