Sanders D, Schneider P, Taylor M, et al. - Researchers performed a prospective randomized controlled multicenter trial in order to assess the relative rate of malreduction after high fibular fractures associated with syndesmosis injury treated with open reduction and internal fixation, with either 2 screws or 1 knotless TightRope device. Twelve months follow-up of 103 patients with OTA/AO 44-C injuries with demonstrated radiographic syndesmosis diastasis or instability after malleolar bony fixation was done after treatment. Using screw fixation vs TightRope fixation, the rate of malreduction was 39% and 15%, respectively. Results here favor using the TightRope device with two, 3.5-mm, 3-cortex screw fixation for syndesmosis injuries.