To investigate the effect of distal tibiofibular joint fusion in the treatment ofold injury of distal tibiofibular Syndesmosis. Methods: From May 2013 to December 2017, 47 patients with old injury of distal tibiofibular Syndesmosis were treated including 27 males and 20 females, aged 29-65 years, with an average of 59.7 years, and the course of the first injury to the operation was 3-9 months, with an average of 5.9 months. The preoperative AOFAS score was (34.2 + 6.9), and the distal tibiofibular joint fusion was used for the treatment.Results: All patients were followed up for 9 to 60 months, with an average follow-up of 37.7 months. After treatment, there was no significant difference in ankle flexion and dorsal extension. AOFAS score was (83.5 7.7) at the last follow-up. The excellent and good rate was 87.2%.Conclusion：the clinical effect in the treatment of old injury of distal tibiofibular with distal tibiofibular joint fusion is worthy of popularization and application.