Abstract
CASE HISTORY: A 22-year-old Division II Collegiate men’s volleyball athlete presented with acute trauma to his left ankle after excessive inversion. No reported recent injuries or disorders affecting ankle or lower extremity, demonstrates partial ability to weight bear and experiencing moderate discomfort. PHYSICAL EXAM: Orthopedic assessment revealed left lateral ankle swelling, ecchymosis, and an open laceration, with no palpable tenderness. A comprehensive lower extremity evaluation identified muscle weakness across all muscle groups and substantially restricted ankle range of motion. Evaluating clinician referred athlete to orthopedic doctor, who recommended X-rays (Figure 1) and an MRI. DIFFERENTIAL DIAGNOSES: ATFL (anterior talofibular ligament) tear, CFL (calcaneofibular ligament) tear, PTFL (posterior talofibular ligament) tear, lateral malleolar fracture, avulsion fracture. TESTS & RESULTS: X-ray showed a displaced distal fibular avulsion fracture. MRI showed a grade three ATFL tear. FINAL DIAGNOSIS: Left lateral malleolar avulsion fracture with grade three ATFL tear. DISCUSSION: Lateral malleolar fractures are often associated with ATFL sprains, particularly when the ankle undergoes forced inversion. The injury mechanism typically involves plantar flexion and inversion. Patients present with pain, swelling, and difficulty bearing weight, with imaging confirming the diagnosis and assessing soft tissue involvement. Treatment depends on fracture stability; stable fractures may be managed conservatively, while unstable and displaced fractures often require surgical intervention to restore alignment and stability. OUTCOME OF THE CASE: The athlete was advised to undergo surgery and reconstruct the affected area to prevent further damage, reduce the risk of chronic injury, and improve pain management. They opted against surgical intervention and chose to pursue conservative treatment through a structured rehabilitation program. Rehabilitation plan included range of motion exercises, strengthening exercises, plyometrics, and progressive activities such as jumping and running to restore function and stability. RETURN TO ACTIVITY AND FURTHER FOLLOW-UP: This comprehensive rehabilitation strategy allowed them to return to collegiate volleyball with improved performance, enhanced quality of life, and markedly reduced symptoms.
Recommended Citation
Bemusdaffer, Carly J. and Schwarz, Antonella V.
(2025)
"Displaced Distal Fibular Avulsion Fracture in a Collegiate Men’s Volleyball Athlete,"
International Journal of Exercise Science: Conference Proceedings: Vol. 15:
Iss.
6, Article 1.
Available at:
https://digitalcommons.wku.edu/ijesab/vol15/iss6/1