Ankle fractures are common and represent approximately a quarter of all lower limb fractures. The general concepts for osteosynthesis techniques for deviated and unstable fractures have undergone little change since the 1960s. The presence of comorbidities and poor soft tissue conditions, especially in elderly patients, is associated with a higher rate of postoperative complications. Intramedullary implants have the advantage of using smaller incisions, which minimizes skin damage allowing for early loading. The present technical note describes the use of the fibular intramedullary nail with a minimally invasive approach to deviated and unstable ankle fractures.