Ankle fractures are common and may be treated nonoperatively or by reduction and internal fixation. Both treatments may lead to nonanatomic healing, called malunions. Malunions lead to joint instability and pathologic load transfer. Arthritic joint destruction may be the consequence. Corrective osteotomies for malunited malleolar fractures have to restore anatomic conditions. Osteotomies of the medial malleolus, lateral malleolus, posterior malleolus (Volkmann's triangle), and the posteromedial corner or combinations thereof described. Corrective osteotomies for malleolar malunions show good results in the majority of mid- and long-term studies. Secondary arthrodesis is needed in about 10% to 15% of patients.

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