NAVIGATE:
Supination External Rotation

Hallmark:
- Spiral fracture of the fibula AT the level of the syndesmosis

Stage I
- Rupture of the anterior tibio-fibular ligament OR
- Avulsion of the tubercle of Chaput OR
- Wagstaff fracture

Stage II
- Spiral fracture of the fibula AT the level of the syndesmosis

Stage III
- Rupture of the posterior tibio-fibular ligament OR
- Fracture of the posterior malleolous

Stage IV
- Rupture of the deltoid ligament OR
- Fracture of the medial malleolous

Chaput fracture

CT-SCAN of a Chaput fracture

Cannulated screw

Small medial malleolar fracture

Small posterior malleolar fracture

Hanging screw technique

Trimalleolar fracture

Posterior malleolar fracture > 25%

Anterior to posterior screws

Widened mortise

5-hole 1/3 tubular plate

Fixation for Wagstaff fracture