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1General considerations

The typical displacement in suprasyndesmotic fractures is lateral, usually with the foot externally rotated. Occasionally the foot displaces secondarily into a posterior displacement.

Careful review of the x-ray images is essential for a full understanding of the mechanism of injury.

Regard the injury as a two-part fracture between the lower leg (tibia and fibula) proximally, and the foot distally. The task will be to place the foot in correct alignment with the leg.

If x-rays are not available, it is safer to correct the deformity clinically, rather than to leave it unreduced.