Purpose: This study is to analysis the outcome of patient with surgically treated Maisonneuve fracture and find out the factors that might influence the outcome. Material and methods: 20 patients who had surgical treatment due to Maisonneuve fracture between February, 2001 to March, 2005 were studied. The patients were followed for at least 1 year and average follow up period was 25 months. The average age was 41 years, 16 were male and 4 were female. Mechanism of injury according to Rouge-Hansen classification was supination-external rotation. In all cases, percutaneous screw fixation was applied proximal to tibiofibular syndesmosis. The screws were removed after 8 weeks under local anesthesis. Clinical, functional and radiographic results were evaluated. Results: 17 cases (85%) showed satisfying clinical and radiographic results. The mean functional score according to Ankle Scoring System was 91 (83 to 95). Complication occurred in 1 case with underlying systemic disease and 2 cases with initial ankle joint dislocation. Conclusion: Surgical treatment of Maisonneuve fracture showed relatively satisfying result. However, initial injury state and accompanying disease seem to have great effect on the result.1