The role of comorbidities in a rare case of sequential atraumatic lateral malleolus fractures

We present the case of a 61-year-old female with bilateral sequential atraumatic Weber C ankle fractures occurring 2 years apart. Her medical history was notable for idiopathic neuropathy, balance disorder, morbid obesity, and vitamin D deficiency. She initially sustained a left-sided Weber C fracture requiring surgical fixation, followed by a similar atraumatic fracture on the contralateral side. Magnetic resonance imaging of the right ankle revealed a supra-syndesmotic fibular fracture with syndesmotic injury, prompting surgical intervention involving fibular osteotomy, locking plate fixation, and tightrope syndesmotic stabilization. To our knowledge, this is the first report of sequential, atraumatic Weber C ankle fractures in the literature. This case highlights the importance of recognizing non-traumatic etiologies of high fibular fractures in patients with impaired balance, altered biomechanics, and metabolic bone disease.