“…10 Supination-adduction (SAD) fracture patterns are relatively less common, representing 5% to 20% of all ankle fractures. 7,14,15 These injuries are caused by an axial load in conjunction with inversion of the talus, resulting in progressive injury starting with rupture of the anteriorinferior tibiofibular ligament (AITFL) and/or a transverse fracture of the lateral malleolus. With continued tension force, a vertical shear fracture of the medial malleolus may occur.…”