Ankle fractures are the most common types of fractures treated by orthopaedic surgeons. As a result of a better understanding of the biomechanics of ankle, improvements in fixation techniques, and findings of outcome studies, there has been a gradual evolution in the effective strategics for the treatment of ankle fractures. The goals of treatment continue to be both a healed fracture and an ankle that moves and functions normally without pain. The development of strategies for the treatment of various patterns of ankle injuries revolves around whether these goals can be achieved more predictably with surgical or nonsurgical means. Certain injury patterns have a better outcome after surgical treatment, while other pateerns are better managed without surgery. Surgical treatment is indicated when congruity of the joint cannot be restored with closed method.