The histopathology of injury to the accessory malleolar ossification center.

The evaluation of a traumatic lower limb amputation specimen revealed an incomplete fracture between the main and accessory malleolar ossification centers. This was not associated with extensive subperiosteal or intraarticular bleeding. This pattern of injury, without any displacement or completion to an unstable fracture, should be considered in a patient with specific tenderness over a malleolus after a twisting injury or direct blow to the ankle.