OBJECTIVE: To summarize the characteristics, treatment methods and efficacy of a case of heel talar bridge combined with anterior talofibular ligament rupture. METHODS: A 27-year-old male patient with long-term recurrent chronic pain in the right ankle was admitted on May 7, 2014, with pain in the right ankle joint both medially and laterally, with the medial side being the most obvious, limited mobility, pain and discomfort when walking, and inability to run and jump. Physical examination: slight swelling of the lateral right ankle joint, mobility: inversion 0-20°, valgus 0-15°, dorsiflexion 0-10°, plantarflexion 0-50°. Anterior drawer test (++), anterior talofibular ligament indentation (++), slight swelling and indentation in the medial aspect of the heel talonavicular joint (++).AOFAS ankle-hindfoot score: 75 points. On MR examination, “The right heel talar bridge was formed, the inner posterior margin of the heel talar joint surface was blurred and gross, the local joint space was significantly narrowed, there were multiple small cystic lesions under the joint surface, and the anterior talofibular ligament was ruptured.” Diagnosis: 1. right anterior talofibular ligament rupture; 2. right heel talar bridge; 3. degenerative lesion of the right subtalar joint. The right anterior talofibular ligament was reconstructed under combined lumbar and rigid anesthesia, and the heel talar bridge and the medial-posterior articular surface of the heel talus were wedge resected and shaped. After the operation, the patient was immobilized in a plaster cast for 4 weeks, and functional exercise was performed after the cast was removed to resume normal walking. RESULTS: Postoperatively, the patient’s pain symptoms disappeared, the foot movement was normal, and the AOFAS ankle-hindfoot score: 99. CONCLUSION: Most heel talar bridges are currently considered to be congenital deformities, but frequent pronation injuries have also been suggested as a cause. The heel-talar bridge changes the normal point of contact and stability of the heel-talar joint, resulting in abnormal force transmission to the foot, which causes discomfort and even pain, and the abnormal force transmission also increases the chance of ankle sprain. Therefore, the heel talar bridge and the anterior talofibular ligament injury interact with each other. Blitz et al. divided the heel and talar bridges into three types: type I is a simple bridge, which can be resected directly; type II is a bridge combined with a flat foot, which can be reconstructed by simple bridge resection combined with flat foot reconstruction, and for severe flat foot, joint fusion is possible; type III is a bridge combined with a flat foot and hindfoot arthropathy, which can be reconstructed by subtalar joint fusion combined with flat foot reconstruction or triple joint fusion. This type of fractionation favors the management of congenital heel-tarrow bridges without considering the combined ligament injury, and is not suitable for traumatic heel-tarrow bridges. Some scholars have also proposed fusion of the articular surface of the medial heel talar lesion. However, partial fusion, which does not address the inversion of the ankle, is prone to re-rupture failure. Triple joint fusion results in severe loss of foot and ankle mobility. In this case, the wedge resection of the bone bridge and medial lesion articular surface only removed part of the articular surface, which had minimal impact on the joint function and could stop the lesion process of traumatic arthritis and eliminate clinical symptoms. Preoperative CT reconstruction was used to assess the site and area of resection, and intraoperative attention was paid to C-arm machine positioning to ensure complete resection of the bone bridge and lesion articular surface, which could effectively prevent the recurrence of the bone bridge. In this case, because of the lateral collateral ligament injury, it was easy to produce inversion of the foot, which aggravated the lesion of the medial heel talar joint surface. In this case, the lateral collateral ligament of the ankle was reconstructed at the same time to avoid inversion of the foot and ankle and to strengthen the stability of the heel-talar joint, and the results were more accurate.