An Unusual Outcome Using the TightRope® System in Syndesmotic Injury Management: A Case Report.

Syndesmotic injuries of the ankle are critical for maintaining joint stability and function, especially during weight-bearing activities. While traditional management involves rigid fixation with trans-syndesmotic screws, limitations such as restricted micromovement, potential screw breakage, and the need for secondary procedures have spurred the adoption of dynamic fixation methods like the TightRope® system (Arthrex, Naples, Florida, US). This report presents a case of a 54-year-old female with complications related to TightRope fixation following open reduction and internal fixation (ORIF) of a bimalleolar fracture. The case highlights the clinical course, surgical management, and outcomes, providing valuable insights into the limitations and potential complications of this technique.