Yang TC, Tzeng YH, Wang CS, et al. - A retrospective study was conducted to present outcomes of fixation of bi-malleolar or tri-malleolar fractures combined with a syndesmotic injury with or without posterior malleolar fracture (PMF), and to determine if syndesmotic screw removal at 6 to 8 weeks or 3 months postoperatively is more beneficial. Researchers examined a sum of 113 individuals (Group I, n=47; Group II, n=43; Group III, n=23) who received open reduction and internal fixation for bi-malleolar (without PMF) or tri-malleolar ankle fracture (with PMF) with syndesmotic injury between January 2013 and December 2017 with at least 24 months of postoperative follow-up. This study's findings demonstrate that for syndesmotic screw removal, the better timing is 3 months, instead of 6 to 8 weeks postoperatively, to reduce the risk of recurrence of syndesmotic instability for tri-malleolar fracture without posterior fragment fixation.