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Abstract Objective To explore the clinical effect of the anterior inferior tibiofibular ligament (AITFL) repair technique with augmentation in the treatment of inferior tibiofibular joint instability.Methods From March 2012 to December 2015，a total of 155 patients with ankle fractures with inferior tibiofibular instability treated in our hospital were randomly divided into two groups.There were 77 cases in AITFL repair with augmentation group treated with anatomical repair of AITFL and augmentation with an anchor.There were 78 patients in screws treatment group underwent standard screw fixation.The fraction defective of inferior tibiofibular joint reduction，inferior tibiofibular re-diastasis，ankle pain，Olerud-Molander ankle function score，and visible medical costs were observed.Results Fractrues in both groups successfully healed.CT scan showed fraction defective of inferior tibiofibular joint reduction were 2.6％ (2/77) and 23.1％ (18/78) in the AITFL group and screw group，respectively.In the later follow-up，no patients had significant re-diastasis of inferior tibiofibular joint in AITFL group，while re-diastasis happened in 8.9％ (7/78) patients in screw group.At 3 months，6 months and 12 months after operation，the results of OMAS in AITFL group were higher than that in screw group，and the difference was statistically significant.No patients needed secondary surgery in AITFL group.But all patients underwent screw removal in screw group.The average visible medical expense of AITFL group was lower than that of the screw group.There was no serious complication in both groups.Conclusion To treat inferior tibiofibular joint instability in cases of posterior malleolus fracture fixation and incomplete rupture of the posterior tibiofibular ligament without posterior malleolus fracture，the technique of AITFL repair with augmentation could be used as a alternative to the inferior tibiofibular screws fixation，and it could be obtained a reliable stability and satisfactory clinical results.In addition，other advantages of the technique included the good tibiofibular joint reduction，simplicity of operation，less damage，quick function recovery and no need for secondary surgery.
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