Preparation of the fracture site

Check that there are no fibers of the anterior fibular ligament trapped between the main fragments, particularly if there has been a bony avulsion of their attachment.  This can be a cause of irreducibility of an apparent simple transsyndesmotic fracture.

Do not strip the periosteum more than necessary.


Preliminary reduction before plate application

Having released the third fragment from between the main fibular fragments as necessary, reduce the fracture by applying light longitudinal traction and rotating the foot internally.