Severe open ankle dislocation after an ATV accident as it flipped backwards while going up a hill. According to staff, he was able to somehow wiggle his toes. After the surgery to reduce and reconstruct the ankle, he recovered quickly. Three months into recovery and he was able to walk and six months in he could run. Open ankle dislocations are usually a result of a severe trauma. Forces are placed on the ankle that cause the bones to fracture or the ligaments to tear, resulting in the dislocation injury. The ankle is an inherently stable joint and the direction of the dislocation depends upon the position of the foot and where the force arises. Most commonly, a dislocated ankle is associated with fractures of the distal ends of the tibia and fibula (called the malleolus) in association with damage to the ligaments that help support the ankle joint. Previous ankle sprains, medial malleolar hypoplasia, weakness of the peroneal muscles and ligamentous laxity are predisposing factors for dislocation