Abstract:Objective To evaluate the clinical effectiveness of Tightrope elastic fixation in the treatment of distal tibiofibular syndesmosis instability. Methods From November 2017 to March 2020, 41 patients with distal tibiofibular syndesmosis instability were treated with Tightrope elastic fixation. The patients in this study ranged in age from 18 to 58, with an average age of 32.73 years. There were 17 males and 24 females, 21 left ankles, 20 right ankles, 14 combined with cartilage injury and 27 without. BMI ranged from 17.41 to 33.74 Kg/m2, with an average of 24.15 Kg/m2. Follow-up time ranged from 14 to 42 months, with an average of 25.44 months. All patients had a clear history of trauma. The distal tibiofibular syndesmosis instability was diagnosed by ankle arthroscopy. The average postoperative hospital stay was 3-5 days, and 6 months of postoperative rehabilitation exercise program was adopted. They were followed up preoperatively, 6 months postoperatively, 12 months postoperatively, and annually thereafter. Follow-up included VAS visual analogue scale, AOFAS Ankle Hindfoot Scale and SF-36 quality of life scale. Complications were also recorded. Results All the incisions were healed in stage I, and there were no complications such as incision infection, neurovascular injury and venous thrombosis of lower limbs. At the last follow-up, the patients all recovered well, exceeding the preoperative level. The scores of VAS and AOFAS before surgery, 6 months after surgery, and 12 months after surgery were statistically significant (P < 0.05), and the scores of SF-36 before surgery, 6 months after surgery, 12 months after surgery and the last follow-up were statistically significant (P < 0.05). Conclusion The distal tibiofibular syndesmosis instability is a special type of ankle injury, and ankle arthroscopy is the gold standard for diagnosis. Tightrope can achieve satisfactory results in the treatment of the the distal tibiofibular syndesmosis instability, and can promote the recovery of the function of the patient""s ankle better.