Fall from horse with injury to the ankle.
Admission plain film.
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Trimaleolar fracture of the ankle with significant displacement and angulation.
Fracture through the medial maleolus, distal fibula and and oblique fracture through the posterior portion of the dital tibia as demonstrated on the lateral view. These trimalleolar fractures are unstable injuries and the degree of talar shift here is significant. As well as being unstable, significant vascular and neurological injury can occur.