Vol. 8, Issue 1, Part A (2026)

Bimalleolar fractures are still common. They often occur in young individuals with a high-energy, velocity-of-impact mechanism. Treatment can be orthopedic or surgical. We report 68 cases of bimalleolar fractures treated orthopedically. Treatment consisted of a full leg cast or a cast boot with or without reduction. The average duration of cast immobilization was 84 days. The average follow-up at evaluation was 12 months, with 49 patients evaluated. Our results were generally satisfactory, with 83.68% excellent or good outcomes. The clinical course was marked by complications such as secondary displacement of the cast (2 cases), malunion (2 cases), nonunion (3 cases), and tibiotalar osteoarthritis (1 case). The total cost of orthopedic treatment with a cast was four times lower than that of surgical treatment. Orthopedic treatment still holds a prominent place in the management of bimalleolar fractures.