Ankle fractures are common fractures. Some epidemiological studies suggest that these injuries are increasing in annual incidence over time (1, 2). Posterior malleolus fracture can occur concurrently with lateral malleolar and medial malleolar fractures or in separation. There are many controversies in the indications of posterior malleolus fixation. Most orthopedic surgeons suggest that large fragments should be fixed (3). A number of different surgical approaches and techniques for internal fixation of posterior malleolar fractures have been reported. In case of malreduction, post-traumatic arthritis of the ankle is common, which may affect their quality of life. Treatment of posterior malleolus fracture is controversial.