placement is not completely
corrected by the measures described, the fibular fracture is exposed
by a free incision and the fragments are levered into position, and if
necessary fixed by lashing with catgut or by other mechanical means.

Mal-union of Pott's fracture may necessitate re-fracture by means of a
Jones' wrench, used in the same manner as for club-foot, or the parts
are exposed by operation; the bone is divided by means of an
osteotome, the foot forcibly inverted, and the limb put up in the same
way as in a recent fracture.

#The Converse of Pott's Fracture--sometimes called "Pott's Fracture
with Inversion."#--This injury is fairly common, and results from
forcible inversion of the foot. The lateral malleolus is broken across
its base, or, in young subjects, along the epiphysial line. The medial
malleolus alone may be carried away, or a portion of the broad part of
the tibia may accompany it.

The foot is inverted, the heel falls back, and the toes are pointed.
In other respects it corresponds to the typical Pott's fracture, and
is treated on the same principles. When Dupuytren's splint is
required, it is, of course, applied to the lateral side of the leg.

#Separation of the lower epiphysis of the tibia# is not common. It
occurs most frequently between the ages of eleven and eighteen, as a
result of forcible eversion or inversion of the foot. It is usually
accompanied by fracture of the diaphysis of the fibula (Fig. 98), and
is not infrequently compound. When the epiphysis is displaced to one
side, the deformity is characteristic. In rare cases the growth of the
tibia is arrested, the continued growth of the fibula causing the foot
to become inverted. The treatment is the same as for Pott's fracture.

[Illustration: FIG. 98.--Radiogram of Fracture of lower end of Fibula,
with separation of lower epiphysis of Tibia.]

#Fracture of the talus# usually occurs as a result of a fall from a
height, the bone being crushed between the tibia and the calcaneus. It
is usually associated with other fractures, and is sometimes
impacted, the foot assuming the position of equino-varus. The
diagnosis is only to be made by exclusion, or by the use of the
Roentgen rays. In interpreting radiograms of injuries in this region,
care must be taken not to mistake the _os trigonum tarsi_ for a
fracture. In uncomplicated cases, the treatment consists in
immobilising the foot and leg in a poroplastic splint and applying
massage.