Abstract
Stable ankle fractures can be successfully managed nonoperatively. Unstable fractures on the other hand should be treated surgically as operative management consistently leads to better outcomes. How to define stability in ankle fractures continues to be acontroversial issue. Better understanding of the mechanism of injury as well as improved knowledge of ankle biomechanics now enables surgeons to define stability after isolated fractures of the distal fibula with high accuracy. The following article describes commonly used methods to assess ankle stability after isolated fractures of the lateral malleolus, including stress tests and the use of weight-bearing radiographs. By adhering to the described criteria more than 90% of all isolated nondisplaced fractures of the distal fibula can be managed nonoperatively with excellent results.
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