4 studies (3 RCT and 1 cohort) that compared the use of bioabsorbable screws to metallic screws for syndesmotic fixation in the treatment of tibiofibular syndesmotic injury were included in this meta-analysis. The purpose of the study was to determine if there was a difference in the complication and infection rate between these two treatments. The results indicated no overall significant difference in terms of the incidence of complications, range of motion and functional outcomes between the groups in the fixation of tibiofibular syndesmosis. (All metallic screws were routinely removed in the studies included and not considered a complication) There may be an increased risk of complications with the subgroup of polylevolactic acid bioabsorbable screws alone compared to metallic screws.