Fractures of the fibula proximal to the distal tibiofibular syndesmosis.

Study of thirty-six cases of fracture of the fibula at levels proximal to the distal tibiofibular syndesmosis established that there are three types, distinguished by the direction of the fracture line, which are produced by different mechanisms: supination-external rotation, pronation-abduction, and pronation-external rotation. Advanced lesions that were seen were severe injuries of the ankle which included rupture of the deltoid ligament or fracture of the medial malleolus and complete diastasis of the distal tibiofibular syndesmosis in addition to the fracture of the fibula. Surgical treatment is necessary in most advanced lesions.