A rare case of bilateral ankle fracture

¹Department of Orthopedic Surgery and Traumatology I, Mohammed V Military Teaching Hospital, Rabat, Morocco, ²Faculty of Medicine and Pharmacy, Mohammed V University, 10100, Rabat, Morocco

^&Corresponding author
Moustapha Etape, Department of Orthopedic Surgery and Traumatology I, Mohammed V Military Teaching Hospital, Rabat, Morocco

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A 62-year-old man with a past medical history of acromegaly who had been on corticosteroids since 2003, was brought to the emergency room for bilateral ankle pain associated with functional impotence following a fall down the stairs due to a stumble resulting in closed trauma of both ankles. On admission, a physical examination revealed grossly swollen and painful mobilization of both ankles. The distal neurovascular examination was normal on both feet. Plain X-rays of the two ankles revealed a bilateral ankle fracture. A computed tomography scan of both ankles revealed: medial and lateral malleolus fractures for the left ankle and medial and posterior malleolus fractures for the right ankle. The patient was then taken to the theatre for one-stage internal fixation. A K-wire and a screw were used for the fixation of the right ankle. For the left ankle, screws, a third-tube plate and a K-wire were inserted. The patient´s initial post-operative course was uncomplicated, and he was discharged on oral analgesics and a 12-week non-weight bearing program was prescribed. Gradual weight-bearing was started at 12 weeks. At four months follow-up, the full range of motion of both ankles was regained. At the last year's follow-up of one year, he had neither ankle pain nor ankle instability.

Figure 1: (A) clinical image showing the deformities of the patient's ankles, predominant on the left side; (B) anteroposterior view of both ankles showing bilateral ankle fractures; (C) transverse sections of both ankles showing bilateral ankle fractures; (D) an anteroposterior X-ray view of right ankle showing fixation with a screw on the posterior malleolus and a Kirschner-wire on medial malleolus; (E) an anteroposterior X-ray view of left ankle showing fixation with a screw and a Kirschner-wire on the medial malleolus and a one-third tube with two compression screws on the lateral malleolus