Fracture-dislocation of the ankle with entrapment of the fibula behind the tibia is a rare condition. Prompt recognition and treatment are necessary to prevent permanent disability. In three of four patients, the injury was managed by closed reduction. If the injury is accurately diagnosed and if traction and medial rotation are applied to the foot while the fibular shaft is pushed laterally, a stable, satisfactory reduction may be achieved. If closed reduction fails, a lateral approach through a small vertical incision directly over the fractured fibular malleolus is sufficient to allow open reduction of the fibula.