Fig. 97.—Syme's Horse-shoe Splint applied to correct backward displacement of foot.
Fig. 98.—Radiogram of Fracture of lower end of Fibula, with separation of lower epiphysis of Tibia.
Operative Treatment.—If the displacement 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.