(Disclaimer: This article is only used for scientific purposes, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: Sprains of the ankle joint are relatively common, and the ankle joint is prone to fracture after sprains, and in this case the patient was sprained to the medial side, and thus suffered from lateral ankle fracture and had a localized deformity, in addition to the common symptoms of pain and swelling. X-ray showed not only the presence of fracture, but also with tibiofibular distal joint dislocation, therefore, surgical treatment was used to restore the stability of the joint with internal fixation of the fracture and the dislocation screws, and the symptoms of pain and swelling in the ankle joint were significantly reduced after the operation, and the quality of sleep was improved. Basic information] Female, 41 years old [Type of disease] Fracture of the lateral ankle with distal tibiofibular joint dislocation [Hospital] Harbin First Hospital [Date of consultation] November 2022 [Treatment plan] Surgical treatment (internal fixation with incision reset screws) + Rehabilitation + Ice packs for cold compresses [Period of treatment] Inpatient treatment for 8 days, outpatient follow up after one month [Treatment effect] Fracture joint reset and fixation, pain relief, ankle joint return to activity. The pain was relieved and the ankle joint resumed its activities. I. Initial Consultation The swelling and pain in the right ankle joint continued to worsen before the patient’s consultation, and because the patient did not elevate the affected limb and used ice packs to apply cold compresses, the tissue exudation was more pronounced, and the symptoms became more and more severe. During the examination, a localized deformity was found on the lateral side of the ankle joint, and the pain worsened with passive movement of the ankle joint, as well as friction sounds coming from the outer ankle area. Therefore, it was suspected that there was a fracture of the outer ankle, and it was suggested that the patient take an X-ray to confirm the existence of such a fracture. The patient accepted the suggestion and underwent an examination, which confirmed that the external ankle fracture was combined with a distal tibiofibular joint dislocation, ultimately supporting the initial clinical diagnosis. The patient was informed of the mechanism of injury and fracture displacement, and after communicating with the patient, he agreed to be hospitalized for surgical treatment with incision and reduction screw internal fixation. In the process of surgery, it was found that the fracture line of the lateral ankle was short, and screws could be used for fixation without using titanium plate, and the use of screw fixation could protect the surrounding periosteal tissues, avoiding excessive stripping of the periosteal tissues and affecting the blood supply of the fracture, and the distal tibiofibular joint could be kept stable after screw fixation to restore the ankle point gap. With rehabilitation training in the later stage, serious traumatic arthritis can be avoided eventually, and the function of the ankle joint can be protected and the service life of the ankle joint can be prolonged. As the fracture and dislocation of the ankle joint will have joint edema, which is not easy to subside in the short term, and the symptoms of swelling and pain will be aggravated in the process of rehabilitation training, it is necessary to cooperate with the ice pack cold compress treatment to inhibit the edema in time and facilitate the rehabilitation training in the later stage. The use of surgical incision and internal fixation can not only restore the stability of the broken end of the lateral ankle fracture, but also make the distal tibiofibular joint reset, so as to ensure that the ankle joint space can be restored. Six days after the operation, the patient realized that the pain and swelling of the ankle joint had been significantly reduced, and the quality of sleep had been improved, and the patient would not wake up at night because of the pain when turning over. However, the ankle joint still had mild limitation of flexion, extension and rotation in the short term, which was related to the fact that the swelling had not yet been eliminated, and it was necessary to continue to elevate the lower limb and utilize gravity to reduce the swelling, and the range of motion of the ankle joint would be gradually improved. The patient was instructed to follow up in the outpatient clinic after 1 month. IV. Precautions We are glad that the patient’s surgery was successfully completed, but the patient still needs to pay attention to avoiding weight-bearing on the ankle joint. The internal fixation screws can maintain the stability of the fracture end, but they can’t bear excessive weight, and they are prone to break or degenerate, so they need to be paid attention to. In addition, oral calcium carbonate tablets can promote bone metabolism and accelerate fracture healing, which needs to be adhered to for a long time. Patients also need to go to the orthopedic clinic regularly for follow-ups and X-rays to confirm the healing of the fracture, which usually heals smoothly in about 3 months. After the fracture has healed, the patient can carry weight and resume daily life, but it is better not to do strenuous exercise, such as basketball or soccer, within one year, otherwise the fracture may occur again. The reason why fracture occurs in the external ankle joint is related to the lack of concentration, relatively weak muscle strength, uneven walking surface and other factors. Patients should strengthen physical exercise, enhance the stability of the ankle joint, minimize wearing high-heeled shoes, change to flat shoes and pay attention to the protection of the ankle joint, which can prevent the fracture of the external ankle. If fracture occurs, X-ray should be taken as soon as possible to confirm the type of fracture and choose the appropriate treatment. And cooperate with the rehabilitation doctor for rehabilitation treatment after surgery to get the best treatment effect.