Fig. 1

In a comminuted fracture of the fibula and a medial malleolus avulsion fracture the standard of care would include an internal plate fixation of the fibula fracture without the elimination of the fracture haematoma. The bone fragments would remain embedded in the ensuing haematoma while the plate fixation would ensure maintenance of the correct axis and length of the healing fibula. On the other hand leaving the haematoma in the medial malleolar fracture depicted here is not feasible. Here the fracture ends have to be repositioned through an anatomical reduction and this includes the removal of the haematoma. This is of special importance as a joint is involved in the fracture and the correct realignment of the bones of the joint has to be ensured