50 patients with acute ankle fractures who underwent open reduction and internal fixation were randomized to general anaesthesia and local anaesthesia with intraoperative liposomal bupivacaine (treatment group), or general anaesthesia alone (control group). The purpose of the study was to compare pain scores between the randomized groups. Patients of the treatment group had significantly lower pain 4 hours after surgery, though no significant differences between groups from 3 days to 14 days postoperatively. Significantly lower percocet intake was also noted in the treatment group up to 48 hours after surgery when compared to the control group. No difference in total morphine use within the post-anaesthesia care unit was observed. Patient satisfaction was similar between groups.