Ankle fractures are so common and most heal well so there is a certain lack of attention for the potential for adverse consequences and the potential to salvage these complications. There is a clear association between ankle fracture malunion and a poor outcome, whilst reconstruction can often be accomplished it can be very difficult. The key lies in accurate assessment, careful preoperative planning and proficiency in specialised reconstructive techniques. In this article, we describe this process using clinical cases to illustrate the management of malunion.