Bilateral simultaneous rotational ankle fractures are an unusual phenomenon that remains unreported in the English literature, and to our knowledge, about ten cases have been reported. The aim of the study was to evaluate and report clinical outcomes of bilateral simultaneous ankle fractures in our institution.

We conducted a review of our two-year experience with patients who had simultaneous bilateral fractures of the ankles and were treated at our institution. The included patients underwent surgical treatment using open reduction and internal fixation. Patients' functional outcomes were assessed using PROMs (patient-reported outcome measures), namely the Short Form-36 questionnaire and the OMAS (Olerud and Molander Ankle Outcome Score).

Two cases (four ankles) of simultaneous bilateral rotational ankle fractures were identified in our institution's records. Both cases were involved in a pedestrian motor vehicle accident. They were both female and had an average age of 22.5 years. Due to an open injury, one ankle underwent staging procedure, and the other three underwent open reduction and

internal fixation with better clinical outcomes. Functional outcomes were measured with PROMs.

Conclusion: Simultaneous bilateral ankle fractures, while uncommon, can have a substantial impact on an individual's mobility and health related quality of life. Early surgical intervention and effective rehabilitation enhance functional results in this devastating journey.