Level IV, case series.

This study suggests a weightbearing radiograph of an isolated lateral malleolus fracture cannot determine deltoid ligament integrity and thus need for fibular operative fixation.

Extra-abdominal periosteal desmoid tumors are uncommon nonmetastatic tumors of the extremities with a propensity for local recurrence. Lesions in the distal extremities are rare; a majority of extra-abdominal lesions occur in more proximal portions of the upper and lower extremities. This article reports a patient with an extra-abdominal periosteal desmoid tumor in the toe. A 37-year-old woman had a mass in her left third distal phalanx that was originally noted 3 years prior to presenting to the authors' institution. She reported the mass expanded during pregnancy. The toe was red and elongated and had expanded to approximately the same size as her great toe. The plantar aspect of the toe was thick and callused, and the toenail was slightly elevated. Marginal excision with retention of the nail was performed without complication. The mass was determined to be an extra-abdominal periosteal desmoid tumor and was successfully removed without recurrence. To date, the patient remains asymptomatic, with no pain and complete sensation in her third toe. Although extra-abdominal periosteal desmoid tumors have been identified in the extremities, to the authors' knowledge none have been reported as far distal as the toe. Identifying this lesion in the distal extremity will allow a hasty diagnosis and treatment in future cases of similar presentation. Knowledge of the existence of this type of tumor in the distal extremity may also assist in narrowing differential diagnoses.