Objective: To investigate the diagnosis, treatment and surgical results of Maisonnouve fracture. Methods: The clinical data of 13 patients with maisonnouve fracture from September 2017 to June 2020 were retrospectively analyzed. There were 8 males and 5 females, age: 23-57 years (mean age: 42.1 years) ; All patients had upper fibular fracture, medial malleolus fracture, posterior malleolus fracture and distal tibiofibular syndesmosis separation, and 1 case of upper fibular fracture was missed before surgery. Operation after soft tissue condition permits,the distal tibiofibular syndesmosis was reduced under direct vision without fixation of the upper fibular fracture.The time from injury to operation was 2-11 days (mean 5.2 days) , the plaster was fixed for 4 weeks, and the lower tibiofibular syndesmosis screw was removed 12 weeks after the operation and the weight was gradually loaded. The patients were instructed to do functional exercises after the operation and were followed up every 2 weeks after discharge. Results: All the 13 patients were operated without any complications such as nerve and blood vessel injury, infection, skin necrosis, DVT formation, etc. The incision was grade a healed and the suture was removed 14 days after operation.The follow-up period was 13-36 months, with an average of 21.7 months. All the fractures healed well,12 cases were taken out with internal fixation, 1 case was not taken out yet. At the last follow-up, The Baird-Jackson scores were 89-100, including 7 excellent cases, 6 good cases and 1 fair case, the excellent and good rate was 92.31% (12/13) . Conclusion: The upper fibular fracture of maisonneuve is easy to be missed. It is very important to check the body before operation and X-ray examination of the whole leg. The length and rotation of the fibula should be restored and the tibiofibular syndesmosis should be fixed anatomically.