Meeks BD, et al. - Medial malleolus fractures were fabricated in 12 matched cadaver pairs in order to assess the biomechanical strength of an innovative method of fixation for medial malleolus fractures using a fully threaded (FT) lag screw that extends to the far endosteal cortex. The average torque for the partially threaded (PT) cancellous screws and for the FT cortical screw was 5.02 ± 2.34 in-lb vs 7.63 ± 3.86 in-lb, respectively. With the use of the FT endosteal lag screw, visual and radiographic inspections exhibited no displacement of the fracture site. Results designate better biomechanical torque with far endosteal fixation with the use of an FT cortical lag screw vs a traditional PT cancellous lag screw in a cadaver model. Furthermore, far endosteal fixation is an alternative surgical choice for medial malleolus fractures that give more strength in comparison with PT lag screws and may prevent downsides related to bicortical fixation.