Single-Stage Hybrid Fixation of a Grade III Open, Unstable Trimalleolar Ankle Fracture with Syndesmotic Disruption and Posterior Talar Subluxation

Introduction: Trimalleolar ankle fractures, which involve syndesmotic damage and talar subluxation, are serious injuries that are complicated by open wounds. This article describes a novel single-stage hybrid fixation strategy designed to address these issues. Case Report: A 65-year-old female was involved in a car accident and suffered a Grade IIIA open trimalleolar fracture-dislocation. Radiographs confirmed the syndesmotic disruption and posterior talar subluxation. She underwent emergency surgery that included open reduction and internal fixation of the medial and lateral malleoli, as well as the use of an ankle-spanning external fixator. Her surgical recovery went smoothly, with fast union and functional mobility restored. Conclusion: This case shows that single-stage hybrid fixation can be a stable and successful approach for treating severe open ankle fractures with various anatomical disturbances.