Fractures into the AnMe-Joint. 153 



3. 309. United Fracture of the Tibia and Fibula into 



the Ankle-joint. — Anterior half of a section of the lower 

 end of a right tibia and fibula — macerated, showing the above. 



The fracture in the tibia has been oblique from above and 

 inside downwards and outwards, while the fracture in the 

 fibula has been from behind downwards and forwards. The 

 lines of fracture in the two bones have met at the interosseous 

 space, just above the ankle-joint. The fracture in each case is 

 soundly united, and the two bones are welded together 

 immediately above the ankle-joint. B. C. I. 1, M. 46. b. 



3. 310. Fracture of Tibia into the Ankle-joint, with 



Anchylosis. — Right tibia, with section through its lower end, 

 passing also through an anchylosed astragalus and os calcis — 

 macerated. 



Evidently this has been a comminuted fracture of the 

 lower end of the tibia, with some displacement forwards of the 

 lower fragment. There is an osseous anchylosis between the 

 tibia and the astragalus, and between the astragalus and the os 

 calcis. G. C. 364. 



(h.) Chiejiy involving the Fibula. 

 3.311. Recent Compound Fracture of the Fibula, 



Astragalus, and Os Calcis.— Lower ends of a right tibia 

 and fibula, with the astragalus, scaphoid, cuboid, and part of the 

 OS calcis — macerated, showing the above. 



The patient was a young man, whose foot had been badly crushed. 

 An effort was made to save the limb, but the wound became septic, and 

 amputation could not be avoided. 



The fibula is comminuted and split into the ankle. The 

 astragalus is also split, and the greater part of the os calcis was 

 removed as loose fragments. G. C. 33/6. 



Presented by Charles W. Cathcart, F.R.C.S.E, 



