. Atlas and epitome of traumatic . Fit LUh. Anst tlReichhchi. Muncncn. FRACTURES OF THE LOWER EXTREMITY. 323 of fractures of the ankle. The abduction or pronationof the foot at the astragalo-crural articulation throws greatstrain on the internal lateral ligament or deltoid the movement is continued, the tip of the internal mal-leolus and not the ligament, as a rule, gives way. As thenext step the foot asa whole, and especial-ly the heel, is forcedagainst the externalmalleolus, and thefibula gives way at itsweakest point a fewinches above the an-kle. In a number ofcases the w
. Atlas and epitome of traumatic . Fit LUh. Anst tlReichhchi. Muncncn. FRACTURES OF THE LOWER EXTREMITY. 323 of fractures of the ankle. The abduction or pronationof the foot at the astragalo-crural articulation throws greatstrain on the internal lateral ligament or deltoid the movement is continued, the tip of the internal mal-leolus and not the ligament, as a rule, gives way. As thenext step the foot asa whole, and especial-ly the heel, is forcedagainst the externalmalleolus, and thefibula gives way at itsweakest point a fewinches above the an-kle. In a number ofcases the weight ofthe body on the ab-ducted foot after theinternal malleolus hasbeen fractured pro-duces a bending andfinally a fracture ofthe fibula, as that bonealone is unable to sup-port the weight ofthe body. Symptoms.—Ac-cordingly, the tip ofthe internal malleolusin a typical fractureof the ankle is ab-normally movable andoften displaced down-. Figs. 146 and 147.—Compound fractureof the ankle in a woman twenty-five yearsof age. Reduction was finally accom-plished after division of the interposedskin. Under strict aseptic treatment re-covery ensued with good function at theankle-joint. ward, while the fibulapresents a fracture above the external malleolus. Byholding the foot in one hand and fixing the leg above theregion of the ankle, abnormal lateral movements, especiallyabduction or pronation of the foot, are possible. In most 324 FRACTURES AND DISLOCATIONS. PLATE 67. Fracture of the Ankle.—Fig. 1.—Normal epiphyseal lines at thelower end of the tibia and fibula. Figs. 2 a and 2 b.—Fracture of the ankle, healed with deformity—i. e., severe traumatic pes planus, after a typical fracture of the and posterior views (Lohrke, male, thirty-nine years old,1896). Figs. 3 a and 3 b.—Backward subluxation of the foot in typicalfracture of the ankle. Figure 3 a represents the living foot, figure 3 bthe skeleto
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