Abstract:Objective To explore the clinical curative effect of Knotless TightRopein acute condylar syndesmosis injury complicated with tibiofibular separation.Methods 56 patients of acute condylar syndesmosis injury complicated with tibiofibular separation undergoing emergency surgery,who were divided into A group and B group randomly.All patients had 3-dimensional CT reconstruction of the malleolus.In A group Knotless Tight Rope were used and in B group tranditional 4.5 millimeter cannulated screw tricortical fixation were used.Suspected cases were check with HOOK test.Follow up schedule include 24th hour,2nd week,3rd and 12th month afteroperation.The observation target include VAS score,AOFAS score,SF-36 score.Posterior-anterior radiograph of ankle were taken 1st week 3rd month and 1st year.Complications were record.One way ANOVA,Chi-square test and t test were used for statistic.α value is defined as 0.05.Results 52 patient were followed up to 12th month.The AOFAS score on the 3rd month are (88.2±16.4) and (76.6±13.6) respectively and is of significant statistical difference.VAS score,AOFAS score and SF-36 score on the 12th month is of significant difference.There were no infection during the following up except 6 case of slow cicatrization of wound.There were 4 heterotopic ossification in A group.There were statisticallysignificant different.But there were no relationship between heterotopic ossification and ankle function.There were no re-separation in A group,breakage of cannulated screw occurred in 6 cases,there were significant statistical difference. Conclusion The Knotless Tight Rope is more appropriate for distal tibiofibular syndesmosis injury,how ever the higher rate of heterotopic ossification will not affect the ankle function.