ABSTRACT
This chapter presents a case study of a 30-year-old man who heard a snap as he fell and could not weight-bear at all while walking his dog in the park. This man has a bimalloeolar fracture dislocation of the ankle with critical ischaemia of the skin. This is an orthopaedic emergency and requires prompt action. If the ankle is left in this position, the skin may tear converting a closed injury into an open one. Analgesia and sedation should be given in a monitored environment by a trained practitioner after consenting the patient. The ankle is reduced by grasping the foot and pushing medially whilst dorsiflexing the foot into the anatomical position. Ankle fracture dislocations need definitive operative management, and the patient should be referred to the orthopaedic team. The timing of surgery depends on the degree of soft tissue swelling. Early presentation with a swift reduction may be amenable to immediate open reduction and internal fixation.
