Objective The aim of this study was to examine the minimum 10 year outcome of displaced and subsequently operatively reduced and anatomically fixed ankle fractures and report on the incidence of osteoarthritis.

Methods A total of 420 patients were treated with ORIF ankle at St James University Hospital from 1989–1994. Notes and x-rays of 112 patients were identified for analysis and 40 patients were traced to be available for this outcome study. Patients were interviewed and both ankles were examined. Plan radiographs of the affected ankle were taken. Scoring system for subjective, objective and radiographic criteria according to Baird and Jackson was used ( maximum 100) 96–100 excellent, 91–95 good, 81–90 fair and 0–80 poor.

Conclusion The long term results of ORIF of the ankle are poor as compared to those described in the literature and depend on the age of the patient and severity of the injury. The incidence of radiological osteoarthritis in this series was 67.5%.