Aims: The purpose of this paper is to review a series of ankle post-traumatic deformities treated by arthroplasty, þbula lengthening, bone graft and correction of the malunion. Methods: 30 cases, mean age 40 (±15), were operated 6–30 months after injury and followed up at 5 years. Clinical Maryland foot score (MFS) and X-ray evaluation were performed pre op and at follow up. After medial revision of bone and soft tissue structures, through a lateral transmalleolar approach, mal-union of the posterior malleolus or sinking of the lateral tibial plafond were corrected using autologous cortical cancellous bone graft covered by its periosteal ßap. Postoperative treatment consisted of immediate continual passive motion weightbearing allowed after an average of 8–12 weeks after surgery. Results: Pre op MFS was 64±8 and post-op it was 82±11. 11 patients had excellent results with normal range of motion, no pain, and no progression of the arthritis. The result in 9 cases was good with a normal range of motion, little pain after long walk, and no progression of arthritis. 7 cases were fair because of a decrease in the range of motion and progression of arthritis and moderate pain. 3 poor cases needed arthrodesis. Conclusions: Fibula lengthening, bone graft and correction of malunion were effective treatment of ankle post-traumatic valgus deformity in order to delay ankle fusion in young patients. The success of the procedure was correlated to the severity of arthritis and the joint congruity obtained by surgery.