The photo above shows a compound open dislocation of ankle!! Open ankle dislocation without an associated fracture is an extremely rare injury due to the strength of the collateral ligaments and the capsular reinforcements of the mortise capsule. They are often open because of the thin layer of tissue that lies over the malleoli. During a traumatic event, 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. The treatment consisted of wound debridement and irrigation open relocation with repair of anterior talo-fibular ligament, and primary closure of the skin. Post operatively the limb was immobilised with an external fixation. Photo by @the_akrish