Fig. 3

This 78-year-old woman was treated with an interfragmentary screw and a TP. During securing of the interfragmentary screw, the far cortex was cracked, and absolute stability was not achieved. The fibula length could not be anatomically maintained using a TP that was not a fixed angle device. a Finally, the reduction accuracy was fair (immediately postoperative radiograph). b One year later, it was malunited (the medial ankle-joint substantially widened), the OA grade worsened (arrowheads), and all distal screws were loosened