Here is a front and side x-ray of a patient with an avulsion fracture of the external ankle. It doesn’t look serious. Peng Jianguang, Department of Orthopedics, Xuanwu Hospital, Capital Medical University Below is the same patient, which is doing an inversion stress test without pre-fixation anesthesia, and you can see that the talus is severely tilted Below is the same patient, without spraining that side of the ankle, doing an inversion stress test, and the talus is slightly tilted. After looking at these four pictures, it is now possible to answer the question of why an external ankle avulsion fracture should be fixed. If the fixation is not secure, the ligament stops carried by the avulsion fracture do not heal or heal poorly, which can cause ligamentous laxity and lead to repeated sprains. Therefore, it is generally recommended that a cast be applied to immobilize the brake. In some cases where the displacement is more pronounced and the fracture mass is larger surgery is also required. So, if you find an avulsion fracture after a sprained ankle, you should take it seriously!