A unique closed abduction-external rotation ankle fracture.

A unique closed abduction-external rotation ankle fracture with a combined medial malleolar fracture and avulsion of the deltoid ligament is presented. Thorough literature search has not revealed a similar case. This report is well documented with an operative photograph, radiographs, and a 20-month followup. A mechanical basis for such an injury pattern is described. The magnitude and complexity of the injuring forces applied to the ankle region in road trauma may lead--as in this presentation--to unusual injury combinations.