Typically, a third-degree ankle rotator externally rotated injury requires surgery. Because third-degree ankle rotational external rotation injuries can lead to localized ankle pain, swelling, decreased athleticism, and habitual breaking of the ankle, surgical management may be necessary in patients who have been mismanaged in the early stages. Surgery is even more necessary in patients who are more athletically demanding. Minimally invasive arthroscopic surgery is chosen for ankle ligament repair, which is a surgical procedure with smaller incisions, faster recovery, and higher patient acceptance. Patients with higher athletic demands may opt for an arthroscopic ligament reconstruction procedure, which is relatively more invasive but has a better recovery. In addition, it is recommended that patients with third-degree ankle rotational external rotation injuries that require surgery go to the hospital in a timely manner and follow the doctor’s instructions to avoid delays.