Fascinating picture!
Looks like he lost the fibularis muscles and tendons, the posterior tibial artery and the peroneal artery; the anterior tibial artery is probably what is keeping the color in the foot - it's pretty big.
That white lump to the right, in the hole, is probably the top of the talus bone - the end of the fibula, before it was broken off, would rest on that bone, on the side the picture was taken from. The tibia rests on the outer side of the same bone (away from the camera), and I don't see the contact; maybe the tibia is displaced upward/forward, maybe the end is broken off that, too. I begin to think perhaps it is - there's a small white 'bar' just across the hole from the white lump; it seems to be on the near side; that may be the end of the fibula. The lower, more rightward structure might be part of the tibia - it seems farther away from the camera, where the tibia ought to be.
That does look like right after the fixation - they probably wouldn't bother if they didn't think it could possibly be rebuilt. I wonder how that turned out. The ankle would certainly be unstable without the muscles at the sides. I would expect the doctors might recommend a below-knee amputation, for all the reasons XavierBreath gave.
(Lessee: Ineffective Coping, Disturbed Body Image, Ineffective Tissue Perfusion - Peripheral, Impaired Walking, Risk for Falls, Ineffective Denial, Decisional Conflict, Anticipatory Grieving, Hopelessness, Impaired Physical Mobility, Acute Pain, Risk for Infection, Risk for Post-trauma Syndrome, Impaired Skin Integrity...)