Avulsion fracture of the lateral malleolus in children.

Five girls under the age of 13 years with recurrent symptoms after ankle injuries were found on radiography to have a bony fragment close to the tip of the fibula. At operation it was found that the fragment was attached to the proximal end of the anterior talofibular ligament except in one case in which the fragment had no ligamentous attachment. In the latter case a rupture of the anterior talofibular ligament itself was also found. There was no sign of ankle instability. Removal of the fragments relieved the symptoms in each girl and it is suggested that the symptoms in such cases are due to the bony fragment rather than to ligamentous injury.