Treatment and Outcome of a “Floating Fibula” Injury

Abstract

Case: We report a case of a rare “floating fibula” ankle injury characterized by dislocation of the proximal tibiofibular joint (PTFJ), syndesmosis disruption, complete deltoid disruption, and tibiotalar dislocation without fibula fracture in a 44-year-old man. Imaging includes preoperative and postoperative radiographs and CT scans. Treatment involved reduction and screw fixation of the syndesmosis and PTFJ with planned screw removal. A successful clinical and radiographic outcome was achieved at the 15-month follow-up. Conclusion: This case highlights the unique features of the “floating fibula” injury and shows that reduction and intraoperative assessment may be more challenging than a typical Maisonneuve injury.