Background. In the world literature only a few cases of medial ankle reconstruction after its traumatic loss were described. The authors have not found similar cases in the Russian-language literature.
 The aim of the study is to show a rare clinical case of a patient with a traumatic defect of the medial ankle and to describe the method of its reconstruction.
 Case presentation. A 52-year-old patient suffered a motorcycle injury resulting in an open fracture of the medial ankle with bone fragment loss. The patient was taken to a medical facility where he underwent primary surgical treatment with wound suturing. Three months later, the reconstruction of the medial ankle with a free iliac crest autograft, medial ankle osteosynthesis and deltoid ligament plasty were carried out at N.N. Priorov National Medical Research Center of Traumatology and Orthopedics. In the postoperative period, immobilization of the ankle joint was performed for 4 weeks followed by the active development of motions and partial weight bearing 8 weeks after the surgery. The AOFAS score 12 months after the reconstruction was 93 points. According to CT scans, complete autograft integration was achieved and no signs of instability of the ankle joint were observed. The patient was satisfied with the performed surgical treatment.
 Conclusion. The most optimal method of treatment in case of traumatic defect of the medial ankle is its reconstruction with a free iliac crest autograft. This allows us to form a graft of required parameters and shape, minimizing the risk of postoperative complications.