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Even without a history of pain at the proximal fibula, a Maisonneuve fracture may be present. Specifically palpate the proximal fibula with each ankle pain/strain patient. Beware of patients who are anticoagulated as there may be rapid swelling which can compress the neurovasculature requiring emergent reduction or surgery. Consider compartment syndrome with signs and symptoms of significant swelling, severe pain (often out of proportion to expected pain based on injury), possibly bruising, and paresthesias.