Objective: To study the therapeutic effect of titanium plate fixation with loops in ankle fractures combined with inferior tibiofibular syndesmosis injuries. Methods: 86 patients who underwent surgical treatment for ankle fractures in our hospital from July 2020 to July 2024 were selected as the research subjects. The patients were divided into the control group (36 cases) and the observation group (50 cases) according to their surgical intentions. Both groups of patients received internal fixation treatment. The control group was fixed with inferior tibiofibular screws, while the observation group was fixed with titanium plates with loops. The surgery-related indicators, postoperative recovery conditions, and recovery conditions of ankle joint and hindfoot functions (AOFAS ankle-hindfoot score for ankle joint and function) of the two groups were analyzed and compared. Result: There were no significant differences between the observation group and the control group in terms of operation time, intraoperative blood loss and hospital stay (P > 0.05). After the operation, the partial weight-bearing time of the observation group was significantly shorter than that of the control group (P < 0.05), but there were no significant differences in the complete weight-bearing time and fracture healing time between the two groups (P > 0.05). At 3 months, 6 months and 12 months after the operation, the AOFAS ankle-hindfoot score of the observation group was significantly higher than that of the control group (P < 0.05). Conclusion: The internal fixation of ankle fractures combined with distal tibiofibular joint injury using a titanium plate with a loop does not prolong the operation time, does not increase the intraoperative blood loss, and compared with distal tibiofibular screw fixation, it can ensure early postoperative recovery and promote the recovery of ankle joint function in patients.