van Leeuwen CAT, et al. - In this retrospective cohort study, researchers compared the long-term outcome in function and pain between patients with an isolated type B fibula fracture treated non-operatively and surgically. The study sample consisted of all consecutive patients (aged between 18 and 75 years), treated non-operatively or surgically between January 2008 and December 2015 for a distal fibula fracture at the level of the syndesmosis without an additional medial or posterior fracture and with a medial clear space ≤ 6mm. Two hundred twenty-nine patients with a mean follow-up of 5.3 years were included. For adult patients with an isolated distal fibula and medial clear space ≤ 6 mm, these fractures can safely be treated non-operatively without proven instability, while avoiding surgical risks and costs and preserving good long-term pain and function outcomes.