Fracture of the tibia with an intact fibula is prone to delayed and nonunion or varus malunion and, as a complication of the latter, late arthrosis of the ankle joint. A less well-known type of malunion is tibial shortening with fibular bowing due to relative fibular lengthening. We present such a case with chronic ankle pain. Late segmental fibulectomy failed to improve the symptoms. We recommend primary segmental fibulectomy in all isolated fractures of the tibial shaft in adults and adolescents, in order to forestall the early and late complications.