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Abstract Objective To investigate the value of the new method in the distal tibiofibular syndesmosis reduction of ankle fracture combined with distal tibiofibular syndesmosis injury during operations.Methods A retrospective analysis of 24 operative cases of ankle fractures with distal tibiofibular syndesmosis injury from February 2014 to May 2017 was performed.There were18 males and 6 females，which aged 24~65 years old.The average age was(37.5±6.9).The reduction of the distal tibiofibular syndesmosis was determined by tibiofibular clear space，tibiofibular overlap，ankle medial space and “the front profile”.Distance from fibular anterior-posterior edge to syndesmosis (G value) were measured on the CT scans.Comparisons were conducted between the X-ray films to evaluate their diagnostic efficacy，with G value as a golden standard.American Orthopedic Foot and Ankle Society (AOFAS) scores were used to assess the clinical outcome.Results Of the 24 cases，4(16.7%) were diagnosed with syndesmosis malreduction evaluated with G value.All the patients were followed up for 12 to 46 months (average，16.6 months).No non-union，screw breakage，or syndesmosis separation after screw removal occurred.The American Orthopaedic Foot and Ankle Society (AOFAS) scoring showed a good/excellent rate of 91.7%.Conclusion The observation of tibiofibular clear space，tibiofibular overlap，ankle medial space combined with “the front profile” can improve the reduction of the distal tibiofibular syndesmosis and function of ankle.
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