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Image challenge
'But why does her foot look so bad…?’
  1. Christopher P Jukes1,
  2. Josh T Luck2,
  3. Kathryn Duke3
  1. 1 Trauma & Orthopaedics, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, UK
  2. 2 Trauma & Orthopaedics, Ashford and St Peter's NHS Foundation Trust, Chertsey, Surrey, UK
  3. 3 Trauma & Orthopaedics, Frimley Park Hospital NHS Foundation Trust, Frimley, Surrey, UK
  1. Correspondence to Mr Christopher P Jukes, Trauma & Orthopaedics, Royal Surrey County Hospital NHS Foundation Trust, Guildford GU2 7XX, UK; christopher.jukes{at}nhs.net

https://doi.org/10.1136/emermed-2020-209510

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    Clinical Introduction

    A 36-year-old female driver was involved in a head-on collision, with a combined speed of 70 mph. After the primary survey, the only injury identified was a painful left ankle/foot, held in a fixed plantar-flexed and pronated position. There were no open wounds and neurovascular examination was normal. Radiographs of the left ankle were performed (figure 1).

    Figure 1

    Initial anteroposterior and lateral radiographs of the left ankle.

    Question

    What is the diagnosis?

    1. Tibialis anterior tendon rupture.

    2. Lateral subtalar dislocation.

    3. Isolated simple Weber B fracture to distal fibula.

    4. Congenital deformity …

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    Footnotes

    • Contributors All contributors have had input and agree on the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.