Isolated fractures of the anterior malleolus of the ankle are uncommon. They most often result from vertical loading or from posterior displacement of the tibia on a planted foot. Fracture of the tibial plafond with a large anterior tibial(anterior malleolus) fragment may require open reduction with internal fixation. Anatomic reduction of the articular surface can be ensured by visualizing the articular surface using an arthroscope during reduction. Two cases wherein this technique has proven effective were described.