Syndesmosis injuries can occur in isolation or associated with ankle fractures, and if not properly treated, the injuries may result in ankle dysfunction (Wake et al., 2020). Syndesmotic screw fixation and suture button fixation are both operative techniques to stabilize the unstable syndesmosis as a result of injuries (Wake et al., 2020). The former is a static fixation with one or multiple screws of different sizes engaging three or four cortices (Bava et al., 2010), while the latter is in nature a dynamic fixation which allows for a certain degree of positional variance while maintaining an accurate syndesmosis reduction (Westermann et al., 2014). Suture button fixation has gained increasing popularity over the use of.....