_Clinical Features._--In a considerable proportion of cases--in our experience in the majority--this fracture is not accompanied by any marked deformity of the foot, and the patient is often able to walk after the injury with only a slight limp. In others, however, the deformity is marked and characteristic (Fig. 94). The foot is everted, its inner side resting on the ground. The medial malleolus is unduly prominent, stretching the skin, which may give way if the patient attempts to walk. The foot, having lost the support of the malleoli, is often displaced backward, and the toes are pointed by the contraction of the calf muscles. There is abnormal mobility--both from side to side and antero-posteriorly--and crepitus may be elicited. The points of tenderness are over the deltoid ligament or medial malleolus, the inferior tibio-fibular joint, and at the seat of fracture of the fibula. Distal pressure over the shaft of the fibula, or on the extreme tip of the malleolus, may elicit pain and crepitus at the seat of fracture. There is usually considerable ecchymosis and swelling in the hollows below and behind the malleoli; and the malleoli appear to be nearer the level of the sole. In Dupuytren's fracture, when the talus passes up between the tibia and fibula, there is great broadening of the ankle. [Illustration: FIG. 94.--Radiogram of Pott's Fracture with lateral displacement of foot.] There is often considerable difficulty in distinguishing a _sprain_ of the ankle from a fracture without displacement, as both forms of injury result from the same kinds of violence, and are rapidly followed by swelling and discoloration of the overlying soft parts. In a sprain, the point of maximum tenderness is over the ligaments and tendon sheaths that have been damaged, while in fracture the site of the break is the most tender spot. The X-rays are useful in the diagnosis of doubtful cases. _Treatment._--In those cases of fracture of the lower end of the fibula in which there is no marked displacement,--and they constitute a considerable proportion,--the limb should be massaged and laid on a pillow between sand-bags, or placed in a box splint for two or three days, until the swelling subsides. Some form of rigid apparatus, such as side poroplastic splints fixed in position with an elastic bandage, which will allow the patient to get about with crutches, is then applied. This is removed daily to permit of massage and movement being carried out--a point of great practical importance, because, if this is neglected, not only does union take place more slowly, but the stiffness of the ankle and œdema of the leg and foot which ensue, prolong the period of the patient's incapacity and endanger the usefulness of the limb.