Fracture-dislocation of the ankle with entrapment of the fibula behind
the tibia is a rare condition. Prompt recognition and treatment are
necessary to prevent permanent disability. In three of four patients, the
injury was managed by closed reduction. If the injury is accurately
diagnosed and if traction and medial rotation are applied to the foot while
the fibular shaft is pushed laterally, a stable, satisfactory reduction may
be achieved. If closed reduction fails, a lateral approach through a small
vertical incision directly over the fractured fibular malleolus is
sufficient to allow open reduction of the fibula.