Injury of distal tibiofibular syndesmosis Is usually associated with pronation-external rotation, supination-extemal rotation or pronation-abduction injuries at the ankle. In general, there are two methods of treatment for injured distal tibioflbular syndesmosis. The first is direct repair of injured syndesmosis and the second is internal fixation with trans-syndesmotic screw for stability of distal tibiofibular joint. The latter method is generally used because the procedure is simple and the outcome is relatively good.

Our patients who had been injured of distal tibiofibular syndesmosis that associated with ankle fractures had treated with open reduction, internal fixation and transfixing screw, and early range of motion exercise was started for decreasing joint stiffness and degenerative change. Between March 1990 and August 1994, twelve patients were treated by open reduction and internal fixation and trans-syndesmotic screw fixation. Early range of motion exercise was started ater 3 weeks, and trans-syndesmotic screw was removed and partial weighting bearing was started at 8-12 weeks after sugery. After full weight bearing, follow up clinical examination and full weight bearing ankle roentgenography was evaluated.

The results was as followed

1. Among the 12 cases, male was 7, Female was 5, and the mean age was 30.7 years and the average follow-up period was 27.3 months

2. Range of motion exercise was started at postoperative day 3 weeks.

3. Trans-syndesmotic screw was removed at postoperative day 8-12 weeks and partial weight bearing walking ambulation was started.

4.The full weight bearing ankle anterior-posterior roentgenography was evaluated.

5. There was 3 complicated cases, traumatic arthritis 1 case, infection with diastasis 1 case and distal tibiofibular fusion 1 case.

6. The excellant and good result were achieved in 9 cases(75%)