(Disclaimer: This article is for scientific purposes only. To protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: In daily life, the ankle joint is subjected to high stress when descending stairs, and if no attention is paid to it, ankle sprains can easily occur, resulting in triple ankle fracture. In this case, the patient presented with such condition 3 hours before the consultation, and after examination, it was confirmed that the triple ankle fracture was combined with distal tibiofibular joint dislocation and ankle dislocation. In order to grasp the timing of surgery, the patient was recommended to be admitted to the hospital for surgical treatment, and the fracture was stabilized by incision and internal fixation, and the patient’s pain was reduced and her condition improved after the surgery. Basic information】Female, 51 years old 【Type of disease】Triple ankle fracture, tibiofibular distal joint dislocation, ankle dislocation 【Hospitalization】Harbin No.1 Hospital 【Time of consultation】October 2021 【Treatment plan】Surgery (incision-replacement titanium-plate screw internal fixation) + rehabilitation + medication (oral calcium gluconate oral solution) 【Treatment cycle】Inpatient treatment for 7 days, outpatient treatment for 1 month later. Follow-up 【Treatment effect】 Pain reduction, condition improvement, ankle joint resumption of activities I. Initial consultation The patient was going downstairs three hours before the consultation when the talus rotated forward, so that the stability of the ankle joint declined for a short period of time, coupled with the lack of muscle strength around the ankle joint and ankle sprain, resulting in a triple ankle fracture, with localized swelling, compression pain and dysfunction, among other clinical manifestations. After an anteroposterior examination of the ankle joint, it was found that not only was there a fracture, but there was also a combination of distal tibiofibular joint dislocation and ankle joint dislocation. Thus, the degree of injury was relatively serious and needed to be treated with surgery as soon as possible. After communicating with the patient, the patient fully understood the seriousness of the injury and the urgency of the treatment, and the reasonable timing of the surgery was within 6 hours after the injury, so as to avoid the swelling from increasing and affecting the surgery. During the treatment, it was found that the fracture block of the posterior ankle exceeded 25% of the articular surface, and the displacement reached more than 2mm, which seriously affected the stability of the ankle joint, and the fracture of the other parts of the ankle cavity caused significant narrowing, and at the same time, caused the joint dislocation. Fixation of the fracture and joint by means of internal fixation screws, titanium plates, and other fixations ultimately restored the stability of the joint as well as the stability of the fracture end. During surgery, care was taken to minimize damage to the periosteal tissue and to protect the blood supply to the fracture end, thus facilitating the smooth healing of the fracture in the postoperative period. After the operation, the patients use calcium gluconate oral solution and increase the sunshine time to promote the activation of vitamin D, which can accelerate the formation of bone scab and fracture healing. The patient’s pain and swelling symptoms were significantly reduced about 3 days after the operation, and after 1 week of treatment, the symptoms were satisfactorily controlled, and the patient could move the foot and ankle joints on his own and start rehabilitation activities, and the flexibility of the ankle joint was restored to a certain extent, and the condition gradually improved. From this, we can see that the cut-and-replace internal fixation is a more suitable treatment method for patients with triple ankle fracture. Early recovery of the patients after the operation can rapidly reduce the swelling, which is conducive to the return of venous blood, thus preventing the formation of venous thrombosis. Precautions: The symptoms of very happy patients have been controlled satisfactorily after treatment, patients still need to check the X-ray regularly to confirm the healing process of the fracture after discharge from the hospital. Three-ankle fracture causes serious local blood circulation disruption, and delayed healing of the fracture may occur, or non-healing, and can also cause traumatic arthritis, which needs to be paid attention to by the patients. In addition, internal fixation is prone to cause stress masking and secondary osteoporosis, so attention should be paid to strengthening bone density, such as oral vitamin D drops, balanced diet, moderate activity to increase muscle contraction. Excessive weight bearing and repeated twisting movements of the foot and ankle joints can easily cause re-fracture, even if the fracture heals, it is not beneficial to the patient’s foot and ankle joints, and attention needs to be paid to it after the fracture has healed. This case had a severe triple ankle fracture, combined with distal tibiofibular joint dislocation and ankle joint dislocation, which is a typical ankle fracture and dislocation case. Due to the timely consultation and treatment, the surgery was completed before the serious swelling of the ankle joint occurred, avoiding the exposure of the internal fixation, and at the same time relieving the local bleeding and increasing the pressure of the soft tissues, so the patient’s postoperative recovery speed was relatively fast. In normal life, we should pay attention to protect the ankle joint, check the bone density regularly to prevent osteoporosis, and participate in physical exercise appropriately to improve the stability of the ankle joint.