Ankle fractures are common lesions in sportive activities and high-velocity trauma, 17% could be open fractures; obese and older women are more prone.Leading to coverage defects, osteomyelitis, and bone loss.Management of open fracture requires an interdisciplinary team, with extensive knowledge in this complex situation.Treatment in the emergency department includes clear documentation of the wound, including contamination, neurologic and vascular status, radiographic diagnosis and early administration of antibiotics and tetanus prophylaxis, provisional reduction, and splint the extremity.A debridement similar to oncology protocol decreased the probability of infection as a complication.The use of negative pressure wound therapy has a positive impact on wound closure and decreased necrosis of flaps and grafts.Fractures of the hindfoot are least prevalent but may have frequent complications.