Lateral malleolus avulsion is uncommon, and fusion of the syndesmosis of th
e ankle joint is usually performed in such cases. Others have reported succ
essful reconstruction of the lateral malleolus with a vascularized fibular
head. A case of reconstruction in a 17-year-old girl, with a free scapular
apophysis flap, is presented and compared with alternative flaps available.
The anatomy and development of the scapular crest with its cartilaginous a
pophysis are discussed.