Fenelon C, Galbraith JG, Fahey T, et al. - Researchers conducted a retrospective observational study of 1,529 consecutive patients that underwent operative intervention for an unstable ankle fracture between 2007 and 2017 with the aim to provide an up to date reference of the epidemiology, fracture and fixation characteristics of operatively treated ankle fractures. In addition, they investigated the number of patients undergoing further surgery through revision, implant removal or ankle fusion. In total, 60.1% underwent unimalleolar fixation, while 31.2% and 5% underwent bimalleolar and trimalleolar fixation, respectively. In 28.6%, a posterior malleolus fracture was evident; fixation was performed in 31.6% of these fractures. Two hundred thirty four (15.3%) patients required a further procedure. 1.4% required revision open reduction internal fixation and 0.8% underwent future ankle fusion. Findings thereby suggest that a sizable part of orthopedic trauma practice involves treatment of ankle fractures with more than one in seven patients necessitating a second procedure. They observed more complex fractures predominantly in older females, while an increased likelihood of requiring future ankle fusion or revision was noted for patients who suffered trimalleolar fractures. Despite this, ankle fusion rate of < 1% was observed.