Abstract: Fractures requiring surgical intervention during pregnancy is rarely seen in clinic, and these patients need special treatment and nursing, necessitating the consideration of both maternal fracture repair and fetal safety.For patients in late pregnancy, they have higher risk of complications, such as premature birth, placental abruption, venous thromboembolism (VTE), and anesthesia-related manifestations during the perioperative period.This article reported a case of a patient at 28 weeks of gestation with medial and lateral malleolar fractures accompanied by ankle joint subluxation and summarized the successful experience of collaboration by a multidisciplinary team (MDT).In terms of nursing, personalized body position management was implemented to relieve inferior vena cava compression; a phased analgesic strategy combining nerve block with drugs safe for the fetus was adopted; continuous electronic fetal heart rate and uterine contraction monitoring were carried out to ensure fetal stability during surgery; VTE prevention was strengthened by combining intermittent pneumatic compression devices with low-molecular-weight heparin; nutritional support and psychological counseling were provided.No complications such as infection, thrombosis, or fetal distress occurred after surgery.The Patient's ankle Kofoed score reached 88 points three months after surgery, indicating good functional recovery.Finally, the patient delivered a healthy male infant at full term, with a good Apgar score, and both the mother and the infant were safe.The case indicates that refined perioperative nursing combined with multidisciplinary collaboration can effectively reduce risks and improve the clinical outcomes of pregnant patients with fractures.