Between 1 January 1981 and 30 June 1987, 104 closed medial malleolar fractures and seven pseudarthroses of the medial malleolus were treated by tension band wiring. The ligaments, capsule and other fractures were reconstructed. Most of the fractures had healed after 8 weeks. We re-examined 97 of the fresh fractures and all seven of the pseudarthroses at an average of 3.8 years after the operation. Of the medial malleolar fractures 92.3 per cent were excellent. In type A fractures 90 per cent were excellent, in type B fractures 92.5 per cent were excellent and in type C fractures 89.36 per cent were excellent. In the group of pseudarthroses six were excellent.