Fractures and fracture-dislocations of the distal tibia and fibula involving the joint are loosely referred to as Pott's fractures.
The type of fracture is dependent on the forces that cause the injury. A malleolus fractured by a pushing force usually fractures obliquely, whereas pulling causes a transverse fracture.
Eversion and external rotation results in an oblique fracture of the lateral malleolus and a ruptured ligament or transverse fracture of the medial malleolus.
Inversion and internal rotation of the ankle causes an oblique fracture of the medial malleolus and a ruptured ligament or transverse fracture of the lateral malleolus.
The position of the fibular fracture is important with regard to management of the condition. A fracture that is above the tibiofibular joint is essentially an unstable fracture-subluxation of the ankle and will require open reduction and fixation. A fracture that is below this point may have some talar tilt but is usually stable enough to be held securely in plaster.
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