Introduction and Purpose: Improper alignment, malreduction and neglecting to foresee syndesmotic injuries in ankle trauma led to persistent post operative ankle pain, delay in recovery and early arthritic changes of ankle joint. The treatment of distal tibiofibular syndesmotic injuries is a major concern in ankle injuries. The objectives of this study is to have Preoperative suspicious, assessment of mode of injury, stress x-rays and intraoperative test for all ankle injuries to avoid missing syndesmotic injuries and there by the treatment. Materials and Methods: This is a prospective study of 28 ankle injuries diagnosed to have syndesmotic injury. All cases are due to RTA or fall while walking. Mostly of Weber type b and c. Compound grade I, II & III A were also included. After clinical and radiological investigations, diagnosis was confirmed and intraoperative test done and bimalleolar fracture fixed first then syndesmotic injury fixed with either single or double cortical screws and with 3 or 4 cortex purchase. Postoperative check x rays taken for checking proper reduction of the syndesmotic joint and level of screw placement. Post operative outcome were measured using AOFAS score chart. Results and Discussion: Results of our study shows excellent (AOFAS 90-100) in 17 cases, good (AOFAS 80-89) in 9 cases, fair (AOFAS 70-79) in 1 case and poor (AOFAS less than 70) in 1 case. With this we come to the conclusion that (1) pronation external rotation injury is the common type. (2) Diagnosis of distal syndesmotic injuries and fixing it is very much important for having pain free stable ankle joint, early mobilization and preventing ankle joint arthritis. (3) Three cortical or four cortical purchase of syndesmotic screw is not significant in postoperative maintenance of reduction. (4) There is no definitive disadvantage if the syndesmotic screws were not removed.

Background: Distal humerus Fractures account for about 0.5 -2% of all adult fractures out of which a significant percentage (50 -70%) of patients present with intra articular and inter condylar involvement; thereby posing operative challenges to the surgeon. An attempt has been made in this study to evaluate the radiological and functional outcome of distal humerus fractures treated with bi columnar fixation. Materials and Methods: Our study consists of 20 post traumatic distal humerus fracture AO type C operated at