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.