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The surgical treatment of elderly patients with unstable ankle fractures is challenging. Open reduction and internal fixation with conventional plating technique often yields a poor outcome. However, fracture management with isolated fibular nailing represents an alternative method. We performed a retrospective study of patients treated with isolated fibular nailing at the North Zealand Hospital, Denmark, between 1 January 2012 and 31 December 2016. A total of 58 patients were included. The primary outcome was post-operative function (