Weber type C ankle fractures are always combined with a complete rupture of the distal tibiofibular syndesmositic ligaments. Operative treatment for these fracture is highly recommended, but opinions differ as to whether the syndesmosis should be transfixed. The purpose of this study was to disclose whether an adequate reduction and a rigid internal fixation of the fracture in the fibula can eliminate the need for further trans-syndesmotic screws. The patients with type C ankle fracture, who were treated between 1984 and 1989 at Chung-Ang university Yongsan hosptial, were divided into two groups according to whether trans-syndesmotic screw was used or not. Group I include 17 patients who had adequate reduction and rigid fixation of the fibula without trans-syndesmotic screw. Group II included 15 patients who had trans-syndesmotic screw with or without internal fixation of fibula. The results obtained from this study were as followings. l. In all cases of Group I that had rigid medial and lateral fixation without trans-syndesmotic screw, early and late stability of syndesmosis could be achieved. 2. There was no significant difference of the clinical results between two groups. This study suggests that trans-syndesmotic screw is bot necessary provided that medial and lateral sides in the type C ankle fractures are well reduced and fixed rigidly with the aids of intraoperative X-ray and stability test.