What is the best diagnosis for a patient with both medial and lateral malleolar fractures?

• A. Comminuted tri-malleolar fracture
• B. Spiral fracture of the tibia and fibula
• C. Distal tibia fracture with severe volar angulation
• D. Both bones fracture

Answer: (A)

The best diagnosis for a patient presenting with both medial and lateral malleolar fractures is best categorized as a comminuted tri-malleolar fracture. This type of fracture is characterized by involvement of both the medial malleolus (the bony prominence on the inner side of the ankle) and the lateral malleolus (the bony prominence on the outer side of the ankle), as well as the posterior malleolus, which is a portion of the fibula at the back of the ankle. The classification as "tri-malleolar" implies that three distinct malleolar structures are affected, making this diagnosis particularly important for treatment and management strategies.

Comminuted fractures, by definition, involve the breaking into multiple pieces, and in the context of a tri-malleolar event, this reflects the complexity and instability of the fracture pattern. In managing these injuries, recognizing the tri-malleolar classification helps guide appropriate surgical intervention to stabilize the ankle joint and achieve optimal healing.

While other options may describe injuries involving bones around the ankle, they do not capture the specific involvement of both malleoli alongside potential additional fracture sites that need to be addressed, which is characteristic of a comminuted tri-malleolar fracture. Hence, this diagnosis