Background: Bimalleolar ankle fractures require precise anatomical reduction and stable fixation to ensure optimal functional recovery. The combination of a medial cancellous (CC) screw and a lateral malleolar plate is widely used, yet outcome data on union rates and postoperative function remain clinically relevant.

Objective: To assess radiological union and ankle function following bimalleolar fracture fixation using a medial CC screw and a lateral malleolar plate in a cohort of 18 patients.

Methods: This prospective study included 18 patients with acute bimalleolar fractures treated with open reduction and internal fixation. Medial malleolar fixation was achieved using a partially threaded CC screw, while the lateral malleolus was stabilized with a plate. Patients were followed for 6 months. Radiographic union was evaluated on standard ankle views, and functional outcomes were measured using the American Orthopedic Foot and Ankle Society (AOFAS) Ankle–Hind foot Score along with clinical range-of-motion assessment. Postoperative complications were recorded.

Results: Radiographic union was achieved in 17 of the 18 patients within 10–14 weeks. One patient demonstrated delayed union but progressed without the need for revision surgery. The mean AOFAS score at 6-month follow-up indicated good to excellent outcomes in most patients. Ankle range of motion approached near-normal values in those without complications. Minor complications included two cases of superficial infection and one case of hardware discomfort, all of which were managed conservatively.