An unusual presentation of tibial plafond fracture post-removal of diastasis screws.

Removal of internal fixation is a common procedure with recognized complication of re-fracture. Bone integrity is known to be compromised by even a single screw hole. After screw removal and return to weight bearing, the advent of minor pain is not uncommon, and with the absence of new X-ray findings, it is rarely investigated further. We present the case of an acute, non-traumatic fracture of the tibial plafond following ankle diastasis screw removal not seen on X-ray.