Abstract: Objective  To investigate the clinical effect of elastic fixation of Endobutton plate with loop in the treatment of lower tibiofibular combined injury.Methods A total of 326 patients with lower tibiofibular joint injury combined with ankle fracture underwent surgical treatment from June 2019 to June 2021 were randomly divided into experimental group (163 cases) and control group (163 cases) by using a random number table. The control group was fixed with traditional steel plate screw, and the experimental group was fixed with elastic steel plate with loop Endobutton.Hospitalization and operation related indexes were compared between the two groups. The American Association of Foot and Ankle Surgery Ankle Function Score (AOFAS) was performed on the two groups at 2 and 6 months after surgery, respectively, and the reseparation rate of the lower tibiofibular union was evaluated and compared between the two groups at 6 months after surgery.Results There were no significant differences in operation time, blood loss, incision length, getting out of bed time and hospital stay between experimental group and control group (P>0.05). The incidence of postoperative complications in experimental group was 2.45%, lower than that in control group (7.98%), and the difference between the two groups was statistically significant (P<0.05).The incidence of postoperative complications in experimental group was 2.45%, lower than that in control group (7.98%), and the difference was statistically significant between the two groups (P<0.05). The AOFAS scores of control group were (74.5±9.2) and (81.3±4.3) at 2 months and 6 months, respectively, and the excellent and good rate was 76.0%.AOFAS of experimental group were (82.3±5.3) points and (91.2±3.8) points at 2 months and 6 months after surgery, respectively, and the excellent and good rate was 93.2%, the above indexes of experimental group were higher than those of control group, and the difference between the two groups was statistically significant (P<0.05).Reexamination 6 months after surgery the reseparation rate of lower tibiofibular combination was 12.8% in the control group and 2.4% in the experimental group, and the risk of reseparation in the experimental group was lower than that in the control group, with statistical significance (P<0.05).Conclusion Elastic fixation using Endobutton plate with loop could be used in the treatment of ankle fracture with distal tibiofibular syndesmosis injury,which has a better effect of traditional internal fixation with plate and screws.

Key words: distal tibiofibular syndesmosis injury, Endobutton plate with loop , elastic fixation