it was a Jepsen type 3 ankle fx.

So I had a patient in the ED today that was involved in a motorcycle accident.
He was intoxicated at the time, still inebriated by the time we saw him.
It probably didn't help that the temperature has been near 100 degrees lately.
The story was that a gust of wind had basically caused him to swerve his bike and lay it down.
He had been clipped by another car and sustained an ankle fracture.
As per protocol, we had cut off the pants to about the knee to get access to his legs.
At first he was fine, normal conversation about the motorcycle, how he got here, etc.
I told him that he was to go to xray and that afterwards he would get put in a splint.
I left to go get plaster, webril, ace wraps, the usual.
End up getting distracted doing floorwork for another hour or 2, by this time it was about 8PM.
Crap. Forgot about splint, run back down to the ED.
The dude is trippling balls.
He's literally in a full on freak out.
He wants to leave AMA, he's hold us responsible for everything, blah blah blah.
He in NO WAY wants me to put on a splint.
His significant other at this time brings him some crutches that they brought in from home, they start to leave.
The patient gets to about the front door of the ED.
I plead one more time that his ankle NEEDS a splint before he leaves.
He won't have it.
He says his ankle's fine, he can walk on it just fine.
Takes 1 step on his ankle, there's a sickenening crunch and the patient crumples to the ground.
We make eye contact as he lays on the ground.
Stare was holdin'.
Ripped jeans, skin was showin'.
Hot night, wind was blowin'.
Where you think you’re goin' baby?