Accurate diagnosis and proper choice of treatment in fractures and fracture-dislocations of the ankle require a knowledge of the mechanisms of injury.Good x-rays, centered over the joint in true anteroposterior and lateral projections, are also prerequisites to accurate diagnosis.Closed methods of treatment may be used in many cases, but certain fractures require open reduction. Surgery must be precise, and, to allow the indicated correction to be made, x-rays should be taken in the operating room before the wound is closed.