In this episode, Dr. Jeff Dikis and Dr. Leland Jaffe discuss ankle fractures and the management of trauma. They share personal stories and highlight the importance of classification systems (or lack thereof) in understanding and conveying information about fractures. They emphasize the need to consider the complexity of ankle fractures and the variety of injuries that can occur. The doctors also discuss the process of evaluating and planning for trauma, as well as the progression of knowledge and decision-making in the field. They touch on the challenges of hospital contracts and product selection. Finally, they engage in a debate on the use of screws versus flexible syndesmotic fixation for ankle fractures. The speakers discuss the indications for each technique and the considerations for different patient populations. The use of an ACL guide for ankle fractures is presented as a novel technique. The conversation concludes with a case presentation and a discussion on the importance of filling the void in medical education.