Trauma of the lower leg is common, both as a result of sports and because of accidents at work. ‘Going over’ on the ankle can simply result in a mild ligamentous sprain, but as the energy involved in the injury rises there is a well defined cascade of fractures and ligament tears associated with each mechanism of injury. Dislocation of the ankle is an emergency because the pressure from the displaced talus compromises the blood supply to the foot and the integrity of the skin that is tented over the bone. Immediate reduction, even if a proper anaesthetic is not available, is appropriate because the neurovascular state of the foot is compromised.

These are commonly associated with contact sports, motor vehicle crashes or falls.