1. The majority of malunited Pott's fractures can be satisfactorily corrected by conservative operations which preserve motion in the ankle joint.
2. In acute trimalleolar fractures (Cotton's type), an open operation should be done when it is impossible to secure satisfactory position at the original manipulation or when the deformity recurs during immobilization. In performing such an operation, it is preferable to use some type of internal fixation for the posterior fragment.
3. In cases of malunion following trimalleolar fractures of the more severe types or of long duration, conservative reconstruction operations result in a high percentage of poor functional results.
4. Fusion of the ankle is indicated as a primary procedure in certain types of malunion where experience has shown that conservative reconstructions are unsatisfactory.
5. Fusion of the ankle is indicated as a secondary procedure in those cases of malunion where a more conservative type of reconstruction has failed.