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Replace the K-wire with a lag screw

Remove the K-wire. Make a stab incision through the deltoid ligament and enlarge the K-wire track with a 2.5 mm drill and protection sleeve.

After measuring the length and tapping the malleolar fragment, insert the second chosen 4.0 mm cancellous bone screw.

The fracture will be suitably fixed with the two cancellous bone screws and the joint surface reconstructed.