Ankle fractures are a commonly encounter orthopaedic injury, with lateral malleolar fractures being the most common fracture pattern seen. Proximal fibular fracture with ankle twisting injuries, termed the Maisonneuve fracture, are much rarer, and are thought to account for 5% of surgical treated ankle fractures. Fracture of both proximal and distal fibular following twisting ankle injury is an extremely rare occurrence, with little reported cases in existing literature. We present one such case of a 45-year-old male who sustained both a proximal and distal fibular fracture following a twisting ankle injury with associated posterior malleolar fracture and anterolateral distal tibial tubercle (Tillaux-Chaput fracture). Both proximal and distal fractures were identified on presentation, and he underwent open reduction internal fixation with single cortical screw fixation of anterolateral distal tibial tubercle, lag screw to lateral malleolar and neutralization plate, and two tricortical syndesmotic screws. His post operative course was unremarkable, and he returned to work after nine weeks. Concurrent proximal and distal fibular fractures following ankle twisting injury is an extremely rare fracture pattern. This case highlights the necessity for thorough physical examination and radiological imaging for all ankle injuries while also highlighting the importance of preoperative computed tomography on surgical planning for ankle fractures.

CT-guided transthoracic lung biopsy is an essential diagnostic technique for evaluating pulmonary lesions. Although rare, major complications such as hemothorax can be life-threatening. We report the case of a 35-year-old woman who developed a rapidly enlarging right hemothorax several hours after CT-guided core needle biopsy of a pleura-abutting right lower lobe mass. There was no arterial extravasation, and chest tube drainage yielded approximately 1500mL of dark, clotted blood, suggesting a venous or tumoral source. The patient remained hemodynamically stable and achieved complete recovery with conservative management. This case highlights that even massive post-biopsy hemothorax can be successfully treated non-operatively in stable patients by adhering to trauma-based management principles.