Abstract: Ankle joint fractures are a common type of intra-articular fractures in orthopedics, often accompanied by lower tibiofibular joint injury. The choice of fixation method directly affects the quality of fracture healing and joint function reconstruction. Currently, clinical internal fixation methods for lower tibiofibular joint injury mainly fall into two categories： rigid internal fixation and elastic internal fixation. Rigid internal fixation, as an absolutely rigid fixation, possesses significant advantages in terms of rigid stability, but it completely blocks the physiological movement of the lower tibiofibular joint and has limitations such as the risk of screw breakage and secondary removal. Elastic fixation methods, represented by the button-suture fixation system, titanium cable looping fixation, and high-strength suture + Nice knot fixation, can effectively preserve physiological micromotion and reduce stress shielding, becoming the mainstream direction in clinical applications in recent years. Previous literature has mostly been limited to horizontal comparisons of single surgical techniques. This article systematically reviewed the advantages and disadvantages of various internal fixation methods, changes in indications, and the latest research controversies, providing evidence-based guidance for the selection of internal fixation methods for ankle joint fractures with lower tibiofibular joint injury in clinical practice.

Key words: Ankle joint fracture, Lower tibiofibular joint injury, Internal fixation, Rigid fixation, Elastic fixation