A 65-year-old female presents to your urban district hospital at 11.30pm having slipped on wet floor and is unable to weight-bear on her L ankle.

Trimalleolar ankle fracture-dislocation

1. State (4) radiological abnormalities present on this X-ray. (4 marks) 4 marks

2. State the overall impression of these X-rays. (1 mark) 1 mark

3. List (6) complications that could be associated with this injury. (3 marks) 3 marks

The foot is pale and has sluggish capillary return. The patient is not fasted and there is no orthopaedic service at your hospital.

4. How does this impact your immediate management? (1 mark) 1 mark

5. What would you tell this patient their ongoing management will require? (2 marks) 2 marks