Eight randomized controlled trials or cohort studies were selected for inclusion in this meta-analysis which compared functional outcome, hardware removal rate, and malreduction rate between dynamic fixation and static fixation of syndesmosis injuries. Functional outcomes were pooled at 3, 6 and 12 months postoperatively. Results demonstrated significant differences in favour of dynamic fixation compared to static fixation for Olerud Molander score at 6 months, and AOFAS scores at 3 and 6 months. Differences between fixation methods at 12 months were not significant for either measure. Rates of hardware removal and malreduction were significantly lower among dynamic fixation groups compared to static fixation groups.
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