[Objective] To investigate the surgical technique and clinical outcome of Maisonneuve fractures. [Methods] A retrospective study was conducted on a total of 13 patients who were surgically treated for Maisonneuve fractures in our department from September 2017 to June 2020. All patients suffered from upper fibular fracture, medial malleolus and posterior malleolus fractures, and separation of the infe- rior tibiofibular syndesmosis. Clinical and imaging findings were evaluated. [Results] All the 13 patients had operation performed successful- ly without fixation of the proximal fibula fracture, whereas with inferior tibiofibular syndesmosis fixed by 2 screws through 3 layers of cortex. No serious complications, such as neurovascular injury, happened in anyone of them during the operation. As time went in follow-up lasted for (21.7±8.0) months on average, the dorsal extension- plantar flexion range of motion (ROM) , AOFAS and Olerud-Molander score in- creased significantly (P＜0.05) , but the varus-valgus ROM remained unchanged (P＞0.05) . Radiographically, satisfactory fracture reduction was achieved in all patients, and no significant changes in TTA, overall ankle alignment, and Morrey-Wiedeman grade of ankle degeneration were noted over time postoperatively (P＞0.05) . [Conclusion] The reduction of the inferior tibiofibular syndesmosis under direct vision does effectively restore the length and rotation of the fibula, and get satisfactory clinical outcomes for Maisonneuve fractures.