Suppuration is rare, disjunction of the epiphysis from the diaphysis common.
The periosteum rarely becomes separated at the line of junction of the epiphysis and diaphysis.
This was no doubt due to the infrequency of extension of the comminuted fractures beyond the junction of diaphysis and epiphysis.
Other tracks took a direction of longitudinal obliquity, and then implicated both epiphysis and diaphysis.
In compound separations of epiphysis, the end of the diaphysis may be pushed through the skin.
The upper end of the diaphysis forms a projecting ridge which may be felt below and in front of the acromion.
Sometimes the separation is compound, the diaphysis protruding through the skin.
On its under aspect is a cup-like depression into which the central pyramidal-shaped portion of the diaphysis fits.
It is seldom pure, a portion of the diaphysis usually being broken off and remaining attached to the epiphysis.
It is usually accompanied by fracture of the diaphysis of the fibula (Fig. 98), and is not infrequently compound.
