Table 1 Inclusion and exclusion criteria

Age ranging from 18–65 years

Pre-existent impaired mobility

Fractures classified as Lauge Hansen supination eversion type 2–3 or 4

Expected insufficient stable fracture fixation with standard surgical technique

Articular discongruity of >2 mm on X-ray

Pre-existent cognitive disability

Necessity for a syndesmosis screw

Tertius fragment requiring operative fixation

Body mass index >30

Diabetes mellitus

Polytrauma patients (ISS ^a >16 or >2 AIS ^b regions involved)

Gustillo 2 and 3 open fractures

Inability to comply with non-weight-bearing mobilization

Inability to comply with follow-up