BACKGROUND The results of surgical treatment of ankle fractures and influential factors were evaluated. METHODS The study ( 1999-2003) included 40 patients (28 men, 12 women) with a mean age of 37.7 years (15-83) who underwent surgical treatment for ankle fractures. The mean follow-up period was 29.6 months (5-66) According to Lauge-Hansen classification, the mechanism of occurence was supination-external rotation in 21 (52.5%), pronation-external rotation in 8 (20%) and supination-adduction in 5 (12.5%) patients, while 6 patients (15 %) were not assessed. Fractures were also classified (Danis-Weber ) as Type A (n= 8; 20%) , B (n = 22; 55%) and C (n =10; 25%) , including 35 (87.5%) bimalleolar fractures. Roberts criteria were used for the final evaluation of the patients. RESULTS Satisfactory union was obtained in all fractures. According to objective criteria, the results were good in 33 (82.5%) , moderate in 3 (7.5%) and poor in 4 (10%) patients, while corresponding subjective results were obtained in 34 (85%), 3 (7.5%) and 3 (7.5%) patients respectively. CONCLUSIONS Improved outcomes can be obtained by anatomical reduction and restoration of the ankle joint, and the tilt of talus, fibular shortening and the dysfunction of the syndesmotic joint can be prevented. In our opinion our method of surgical treatment influenced better outcomes obtained.