Surgical Versus Nonsurgical Treatment of Fibular Fractures: A Prospective Randomized Study

Inclusion Criteria: * Skeletally mature patients ≥ 18 years of age with acute, closed bimalleolar and/or trimalleolar ankle fractures * Operative fixation of the ankle fracture is within 3 weeks from date of injury * Bimalleolar and/or trimalleolar ankle fractures in which the medial malleolus fragment is greater than 1.7cm wide on lateral x-ray imaging * Bimalleolar and/or trimalleolar ankle fractures in which the posterior malleolus fragment is less than 20% of the depth of the tibial articular surface Exclusion Criteria: * Skeletally immature patients \< 18 years of age * Single malleolar ankle fractures * Open fractures * Operative fixation of the ankle fracture is more than 3 weeks from date of injury * Bimalleolar and/or trimalleolar fractures in which the medial malleolar fragment is less than or equal to 1.7cm wide on lateral x-ray imaging * Bimalleolar and/or trimalleolar ankle fractures in which the posterior malleolus fragment is greater than or equal to 20% of the depth of the tibial articular surface * Ankles with previous fractures of the medial and/or lateral malleolus requiring operative intervention