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.