Abstract
Ankle fractures account for approximately 9% of all adult fractures annually. The ankle anatomically is particularly vulnerable to significant skin compromise in the setting of trauma. Significant fracture blistering and soft tissue compromise is predominantly seen in high-energy ankle injuries. Hereditary sensory autonomic neuropathy type I is a rare progressive neurological disorder resulting in distal sensory loss and autonomic disturbances with variable motor involvement. We present a case involving a hereditary sensory autonomic neuropathy type I patient with unexpected significant soft tissue injury on the background of a low energy ankle fracture. The aim was to outline the diagnosis and complex management considerations related to hereditary sensory neuropathic-associated ankle injuries.