Introduction:

Ankle fractures are among the most common injuries treated by orthopaedic surgeons. Malunion is one of the possible complications, and corrective surgery is often used to avoid long-term disability. However, few studies address medial malleolus malunion and the best revision surgery technique is controversial. We describe a new surgical technique, the «box resection».

Material and methods:

We present two cases of medial malleolus malunion with secondary talus lateral translation and syndesmotic incongruence. In order to restore a congruent tibiotalar joint, we performed the described technique.

Results:

We record significant improvement of AOFAS Score and range of motion in both cases, with resolution of pain symptoms. Postoperative radiographs show a congruent mortise with syndesmosis reduction.

Conclusion:

The box resection allowed immediate talus medial translation to its original position. It is a simple and effective solution, with a good functional outcome.