Staged Management of an Open Bimalleolar Ankle Fracture Combined With Calcaneum and Lisfranc Injuries: A Rare Presentation.

The simultaneous occurrence of an open bimalleolar ankle fracture with ipsilateral calcaneal fracture and Lisfranc fracture-dislocation within a single extremity represents an extraordinarily rare constellation of injuries resulting from high-energy trauma. When associated with a Gustilo-Anderson Type IIIB soft-tissue defect, traditional open reduction and internal fixation (ORIF) carries an increased risk of deep hardware infection, wound breakdown, and osteomyelitis. The extensive soft-tissue injury further complicates management and may preclude immediate internal fixation. This report demonstrates the successful implementation of a staged management strategy that prioritized soft-tissue preservation over immediate rigid osteosynthesis. The patient achieved a functional, plantigrade limb and was able to perform activities of daily living and return to vocational activity, with an AOFAS score of 78 at six months of follow-up.