When backward displacement of the heel is the prominent deformity, _Syme's horse-shoe_ or _stirrup splint_ (Fig. 97) may be employed. It is applied to the anterior aspect of the limb, which is carefully padded to prevent undue pressure on the edge of the shin bone. After the upper end of the splint has been fixed, the heel is pulled forward by a few turns of bandage passed over the prongs at the lower end of the splint. The foot is then inverted and brought up to a right angle by a few supplementary turns of the bandage. In a few days this appliance may be replaced by a poroplastic splint. [Illustration: FIG. 97.--Syme's Horse-shoe Splint applied to correct backward displacement of foot.] _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. #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.]