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Lateral Malleolus

Dr. Sumaiya Khan
Lateral malleolus is the lower extremity of the fibula, which is commonly referred to as the calf bone. The given story provides information on the location and the structure of lateral malleolus.
Tibia and fibula are the two long bones that are located on the inner (medial) and outer (lateral) side of the lower leg respectively. Fibula, which is commonly referred to as the calf bone, is thinner than the tibia (shin bone), and runs parallel to it. Talus refers to the ankle bone that articulates with tibia and fibula to form the ankle joint.
Positioned below the ankle joint is the subtalar joint, that is formed by the talus and the calcaneus (heel bone). The term 'malleolus' refers to the two rounded bony protuberances that are present on each side of the ankle. The bony protuberances located on the outer and the inner side are referred to as lateral malleolus and medial malleolus respectively.
Lateral malleolus is a protuberance that is formed by the lower or distal extremity of the fibula, on the lateral side of the ankle.

Location of Lateral Malleolus

This bony prominence has a triangular articular facet on the anterior section of its medial surface that articulates with the lateral aspect of the ankle bone. The lateral surface has a convex shape and is subcutaneous. It is continuous with the triangular area on the shaft of the fibula.
Malleolar fossa, which is a depression that lies behind this articular facet, serves as a surface for the attachment of the posterior talofibular ligament. Both anterior talofibular ligament and posterior talofibular ligament pass from the tip of the lateral malleolus, and connect it to the heel bone. These ligaments provide stability to the ankle joint.
The calcaneofibular ligament, which originates from the anterior part of the lateral malleolus, passes from the lateral malleolus to the heel bone.
The anterior border is thick and rough, with a depression for the attachment of the anterior talofibular ligament, whereas the posterior border is broad and presents a passage for tendons. The summit is the portion that is round and this is the region that provides attachment to the calcaneofibular ligament.

Medial Malleolus

Medial malleolus, which is also called internal malleolus, is the prominence that is formed by the distal end of the tibia on the medial or the inner side of the ankle.
The deltoid ligament, which is also referred to as medial collateral ligament of the ankle, is a triangular-shaped ligament that binds the shin bone, ankle bone, heel bone and navicular bones together. The fibers of this ligament connect the medial malleolus to the talus at many places.
The lateral malleolus projects or descends to a lower level than the medial malleolus.

Lateral Malleolus Injuries

A lateral malleolus fracture could occur in the event of trauma to the fibula. Runners, sprinters, or those involved in high-speed contact sports that involve changing direction while running (soccer, rugby, basketball) come in the high-risk group for such injuries.

Causes and Symptoms

The ankle joint could get fractured due to an awkward landing from a jump, or rolling/twisting of the ankle while running. Downhill running or running on a hard, uneven surface could also cause severe ankle sprains that may be characterized by damage to the lateral malleolus.
A break in the lateral malleolus could be due to a fall or direct blow to the outer ankle. The symptoms of a lateral malleolus fracture include:

◘ Pain in and around the ankle and the lower leg
◘ Pain that worsens while standing or walking
◘ Swelling
◘ Bruising
◘ Tenderness at the site of injury

Diagnosis and Treatment

An X-ray examination and bone scans are usually conducted to identify the type of fracture, as well as the extent of damage.

◘ If the injury is mild, the RICE (Rest, Ice, Compression, Elevation) approach may be incorporated to speed up the recovery process.
◘ Protective boots, compression bandage, or an ankle brace could be used provide support to the affected leg.
◘ Application of ice packs can help to reduce swelling, whereas the use of heating pads may provide relief.
◘ The patient may also need to use crutches or a wheelchair to avoid placing any extra weight on the ankle in the early weeks of healing.
◘ Drug therapy may involve the use of painkillers and non-steroidal anti-inflammatory drugs.
◘ Surgical intervention might be needed in case of a serious injury involving extensive damage to the bones.
◘ Physiotherapy sessions are often an integral part of treatment in case of fractures.
◘ The affected individual may also need to perform exercises for strengthening the ankle joint and restoring the normal range of motion of the joint.
It extremely essential to comply with the guidelines given by the doctor so as to recover the normal range of motion.
Ankle injuries that involve damage to the lateral malleolus could occur while running, which is why runners, sprinters, and those who play high-speed sports must seek medical help if they experience the symptoms associated with ankle fractures.
Refrain from running on a hard, uneven surface and wear proper running shoes to prevent the occurrence of such injuries.
Disclaimer: The information provided in this story is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.