Irreducible fracture-dislocation of the ankle caused by an entrapped medial malleolus at the syndesmosis.

A 55-year-old fisherman sustained an unusual and irreducible fracture-dislocation of the ankle joint. An entrapped medial malleolar fragment was discovered by computed tomography between the distal tibia and lateral malleolus. The fragment was removed during an emergent open reduction, during which deltoid ligament repair and internal fixation of the bimalleolar fracture were undertaken. At the 18-month follow-up visit, the patient was working normally and was asymptomatic. At previous visits, he demonstrated a full range of ankle motion and had normal radiograph.