Treatment of patients presenting early
The aim of any reduction (early or late) is to correct the displacements.
Treat the patient as soon as possible, when the deformity is typical, late swelling has not yet appeared and adequate anesthesia can be administered.
Use gravity to help to reduce the fracture.
The patient lies supine on the table, with the lower leg hanging over the end of the table.
For laterally displaced and externally rotated injuries (trans- and suprasyndesmotic injuries), hold the heel of the injured foot as shown and lift the externally rotated leg. In this procedure the weight of the leg will, in most cases, reduce the posterior and the lateral displacement automatically. Further pressure against medial or lateral malleoli is usually unnecessary.