In this study the timing of fracture fixation was at the discretion of the treating surgeon and usually this decision is associated with the severity of soft-tissue swelling. The decision to delay fixation is related to a lower rate of soft-tissue complications due to several factors including being able to undertake the ORIF procedure during the day when meticulous focus can be place on the accuracy of the reduction. It appears from this study that a delayed ORIF will not increase the likely hood of osteonecrosis, and that posttramautic arthritis may be more consistently associated with a talar body, tibial plafond, or calcaneal fracture than with the timing of the fixation.