Beckett Nathan C, Long Jeremiah R, Karsen Phil J, Patel Karan A, Flug Jonathan A, Dahiya Nirvikar, Melville David M
Mayo Clinic Alix School of Medicine, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA.
Department of Radiology, Mayo Clinic, 5777 E. Mayo Blvd, Phoenix, AZ, 85054, USA.
Skeletal Radiol. 2025 Sep 26. doi: 10.1007/s00256-025-05040-y.
An os subfibulare is an ossicle that is located distal to the lateral malleolus near the distal fibular tip and typically at the fibular attachment of the anterior talofibular ligament (ATFL). Although there is debate concerning whether these ossicles are unfused accessory ossification centers versus non-united ATFL avulsion fractures, they are seen frequently in the setting of ankle instability. We present a case of an active patient with an unstable os subfibulare contributing to painless "catching" of the ankle due to talar subluxation and locking. This report details the clinical presentation, radiological findings, including MRI and dynamic ultrasound in the "locked" position, and surgical treatment for this unusual presentation of this unstable ossicle. The case underscores the potential importance of the os subfibulare in a patient with ankle instability and highlights the role of advanced imaging in guiding effective treatment.
腓下骨是位于外踝远端、腓骨尖附近，通常在前距腓韧带（ATFL）腓骨附着处的小骨。尽管关于这些小骨是未融合的副骨化中心还是ATFL未愈合的撕脱骨折存在争议，但它们在踝关节不稳的情况下很常见。我们报告一例活跃患者，其不稳定的腓下骨导致距骨半脱位和锁定，引起踝关节无痛性“卡顿”。本报告详细介绍了临床表现、影像学检查结果，包括“锁定”位置的MRI和动态超声，以及针对这种不稳定小骨异常表现的手术治疗。该病例强调了腓下骨在踝关节不稳患者中的潜在重要性，并突出了先进影像学在指导有效治疗中的作用。
