1. This paper presents a series of 135 patients with displaced ankle fractures treated by rigid internal fixation followed by early joint exercises in bed until movements were restored and followed then by full weight bearing in a plaster.

2. The advantages obtained are as follows: A high standard of reduction can be achieved and maintained. The joint movements are established before organisation of the traumatic exudate. Weight bearing in a plaster reduces the degree of disability and prevents osteoporosis. Further remedial treatment after removal of the plaster is usually unnecessary.

3. All but five of the fractures (3·7 per cent) could be classified in the manner described by Lauge-Hansen.

4. This classification is the most satisfactory of those available and is recommended for general use.

5. Anatomical reduction was obtained in 102 patients (77 per cent), with good objective clinical results in 108 patients (82 per cent).

6. The quality of the clinical result depends mostly on the accuracy of the reduction, to a lesser extent on the degree of initial displacement, and least on the type of fracture.

7. It is considered that the traditional concept of diastasis requires modification; it is felt that the term lateral ankle instability, which includes low fracture of the fibula (intraosseous diastasis) is preferable.

8. Internal fixation of the syndesmosis is to be avoided except in rare instances.

9. The incidence of arthritis is shown to depend mostly upon the accuracy of reduction; the initial degree of displacement is also of importance.

1. A simple method of internal fixation of adult forearm fractures which gives consistent good results is necessary because the closed method of treatment is of limited application.

2. Open reduction of fractures without rigid internal fixation gives a high proportion of non-union and poor results.

3. Rigid internal fixation with standard plates and screws has been shown to give a low incidence of non-union in this series.

4. A three and a half inch long plate with six screws is suitable for most fractures, but if there is moderate or severe comminution, or if there is a segmental fracture, longer plates and more screws should be used to provide sound fixation.

5. Severely comminuted fractures with large avascular bone fragments should have the addition of a bone graft at the time of the plating operation in order that union may be assured. Thin strips of iliac bone are preferred.

6. Rigid plating is considered to be the most satisfactory treatment for open fractures.

7. Immobilisation of the limb after operation is not necessary and is undesirable if the fixation is rigid.

8. The functional results of this treatment are good and seemingly better than those achieved by other methods.

9. Serious complications of the plating operation are few and avoidable.