26-year-old man was brought into our emergency de-partment by ambulance after a relatively minor fall at abuilding site approximately 40 minutes previously. Thepatient had been carrying a heavy load in his arms when hisright foot slipped between two concrete slabs. The patient fellforward and twisted his ankle at the same time.On arrival in the emergency department, the patient wasin obvious distress from the pain. Examination revealed a90-degree rotation (fracture-dislocation) of his right ankle(Figs. 1 and 2). There were no other significant injuries.Immediate relocation of the ankle joint was indicated.Because of the painful nature of the injury, intravenous ac-cess was established for the administration of analgesics. Theankle joint was successfully relocated under conscious seda-tion (Fig. 3).Radiography (after relocation of course) revealed a com-pound fracture of the right distal fibula and fracture of themedial malleolus (Weber C) (Fig. 4), which was internallyfixed in the operating suite. Recovery of the patient wasuneventful after this.This case underlines the importance of urgent relocationof a dislocated ankle joint. This is often more difficult whenassociated with a fracture, under which circumstances anes-thesia may be necessary in the emergency room for success-ful emergency management.