Fractures of the lower leg, ankle, hindfoot, midfoot, and forefoot are common injuries. Etiology involves accidents and fall from heights as well as sports related injuries. Clinical symptoms involve pain, swelling, and hematoma formation as well as limping. A precise and sport disciple focused history and clinical examination is essential. X-Rays are obtained most often, depending on the expected injury, ultrasound, CT or MRI scans can provided helpful additional information to facilitate an appropriate classification. For all fractures it is essential to search for tendon or ligament injuries which need to be addressed as well. An overlooked soft tissue injury poses a potentially irreversible threat to recovery, especially in athletes. Anatomical reconstruction of the joint lines as well as soft tissue repair and balancing is the key to success, allowing a fast individually adapted rehabilitation program bringing our patients back to sports. In professional athletes the rehabilitation time frame might vary strongly and the individual rehabilitation program has to be adjusted to fasten the return to the pre-injury level.