The ankle is a complex, weight-bearing joint and is a subject to many types of injuries. The authors reviewed 168 cases of the ankle fractures in 166 patients with operation at the Department of Orthopaedic Surgery, Dong Kang Hospital, from January 1984 to December 1989. We found some factors influencing the adverse result; those are the old age group, pronation-external rotation type of injury, operation between 6 hours and 5 days after injury, severe initial displacement of the talus, posteromedial direction of insertion of the transfixing screw, removal of the transfixing screw within 8 weeks after operation, remained talar shift or tilting, associated osteochondral fracture of the talus, inadequate reduction of the medial joint space, etc.