What is the name of the avulsion fracture of the fibula from the AITFL?

• A. Tillaux fracture
• B. Weber fracture
• C. Maisonneuve fracture
• D. Wagstaffe fracture

Answer: (D)

The name Wagstaffe fracture refers to an avulsion fracture of the distal fibula pulled off by the anterior inferior tibiofibular ligament (AITFL). In an external-rotation or dorsiflexion injury, the AITFL can tear away a small fragment of the fibula as it tugs on the tibia, producing this avulsion fragment at the ankle joint site. This pattern is distinct from other ankle fracture types: Tillaux is a distal tibial physeal fracture in adolescents; Weber describes fibular fractures near the ankle with varying involvement of the syndesmosis but not specifically an AITFL avulsion; Maisonneuve is a proximal fibular fracture with syndesmotic injury and often medial malleolus involvement. Recognizing the distal fibular avulsion from the AITFL as a Wagstaffe fracture helps differentiate it from those other patterns and guides appropriate management.