Cases of extradural haematoma (EDH) are often encountered in the emergency department in patients with multiple traumatic injuries. If the haematoma is small, non-expanding and asymptomatic, it is often managed conservatively. However, other injuries sustained during trauma may require surgical intervention, during which anaesthetic management can become challenging. Here, we present a case where closed reduction and intramedullary nailing was done for a right tibia fracture, successfully performed in a patient with traumatic EDH under combined femoral and popliteal sciatic nerve block with supplementary dexmedetomidine infusion for sedation.