The Inyo nail is a new intramedullary device for the treatment of fractures of the distal fibula. It is a tapered V-shaped nail made of malleable stainless steel, which provides rigid fracture fixation. Torsional stress is resisted because of its triflanged shape. It may be introduced closed, using the image intensifier. Two groups of patients were evaluated: Group I was treated with the Inyo nail and Group II was treated by the Association For the Study of Internal Fixation (ASIF) technique. Eighty-five percent of the patients in Group I were rated as good, compared with 63% in Group II. There was significantly less morbidity and complications in Group I. Several factors must be observed in the treatment of ankle fractures. Stress radiographs must be obtained intraoperative. Surgery may be indicated in unstable supination lateral rotation Type II injuries, if these occur in patients with high physical demands. Anatomic reduction of the lateral malleolus must be obtained. Early weight-bearing and motion produces the best result. Late reconstruction of malunions can be accomplished using the Inyo nail.