Abstract: [Objective] To compare the effects of different surgical methods on the treatment of distal tibiofibular syndesmosis dissociated ankle fractures combined with deltoid ligament injury. [Methods] A retrospective analysis was performed on 82 patients with ankle fractures complicated with distal tibiofibular syndesmosis dissociated and deltoid ligament injury who received surgical treatment from January 2013 to June 2019. According to the surgical methods, they were divided into study group and control group, 41 patients in each group. The study group was treated with deltoid ligament repair, while the control group was treated with inferior tibiofibular screw internal fixation. Perioperative, follow-up and imaging data were compared between the two groups. [Results] All the 82 patients successfully completed the operation without any serious complications. The length of hospital stay, fracture healing time and joint recovery time of patients in the study group were significantly shorter than those in the control group (P<0.05), and 1 patient in the control group was re-hospitalized due to poor reduction position after surgery. All patients were followed up for more than 12 months. As time went on, AOFAS score in both groups gradually increased (P<0.05). AOFAS score in the study group was significantly higher than that in the control group at T1, T2 and T3 (P<0.05). There were no significant differences in MCS, TFCS and TFO between the two groups on the day after surgery or 12 months after treatment (P>0.05). [Conclusion] The treatment of distal tibiofibular syndesmosis dissociated ankle fractures combined with deltoid ligament injury with deltoid ligament repair has a good clinical effect, can significantly improve the ankle function of patients, promote the recovery of joint function, this method is worthy of promotion and application.