The X-ray shows undisplaced medial malleoli fracture . As these fracture have an high incidence of nonunion, we would suggest screw fixation as advised by the doctor
Due to his medical problems, the fitness for surgery is determined by the doctors
It can be treated with plaster considering the risk of non union , which will need Surgery as the only option
Next Steps
Discuss with the Orthopaedic and anaesthetic team
Health Tips
Pros and cons before making any decision