Schiavi P, Pogliacomi F, Garzia A, et al. - This study was undertaken to investigate the outcomes of patients affected by posterior and medial malleolar ankle fractures associated with a distal tibial fracture who underwent intramedullary nailing at a follow-up of 3 years. Between 2006 and 2016, researchers compared all treated patients (group 1) with a control group (group 2) without ankle lesions. They documented and examined demographic variables and data related to surgical procedures and hospitalization. The OMAS and DRI scores were applied to assess clinical outcomes. Thirty-six patients in group 1 and 36 in group 2 were included in the study. Clinical results seemed similar. The data exhibited that in group 1, no osteoarthritis was documented as a consequence of good articular reduction that is better and more easily executable whether malleolar ankle fractures are fixed before intramedullary nailing. CT has always to be conducted to recognize associated ankle lesions as it may modify the surgical plan, postoperative management, and outcomes in distal tibial fractures.