The lateral malleolus is the distal expanded end of the fibula forming the lateral wall of the ankle mortise, projecting approximately 1 cm more distally than the medial malleolus. Its articular surface contacts the lateral talar facet and its posterior surface has the fibular groove for the peroneal tendons. The lateral malleolus provides attachment for the ATFL, CFL, PTFL, and inferior tibiofibular ligaments.
The lateral malleolus is the most commonly fractured bone at the ankle. Weber classification (A below, B at, C above the syndesmosis) guides surgical management. Posterior fibular groove depth determines peroneal tendon stability. Avulsion fractures at the ATFL or CFL attachments must be distinguished from lateral process talar fractures on ankle X-ray. Lateral malleolus osteotomy provides access to the posterior ankle joint for hindfoot procedures.
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