Abstract: [Objective] To explore the application of ankle arthroscopy in the evaluation and treatment of ankle joint fractures combined with inferior tibiofibular syndesmosis injury. [Method] A total of 80 patients with ankle joint fractures and inferior tibiofibular syndesmosis injuries treated in our hospital within 4 years were randomly selected, and 35 patients treated with open fixation were defined as the open group; patients treated under ankle arthroscopy There are 45 cases, which are defined as the under-mirror group. Observed data include osteochondral injury, AOFAS ankle function scores before treatment and 3 and 6 months after treatment, and perioperative conditions. [Results] The follow-up of patients in the microscope group was significantly better than that in the open group, and the difference was statistically significant (P<0.05). After 3 and 6 months of treatment, the AOFAS ankle function score of the patients in the microscope group was significantly higher than that of the open group, and the osteochondral damage was better than that of the open group. The difference was statistically significant (P<0.05). [Conclusion] Ankle arthroscopy is a good way to evaluate ankle joint fractures combined with inferior tibiofibular syndesmosis injury, and has a good effect in the treatment.