Each of the syndesmotic ligaments has different biomechanical effects. Minimal movement occurs in the syndesmosis during the motion of the ankle joint, and the syndesmotic injury is associated with the ankle position and the patterns of external forces. Controversy still exists with respect to the optimal fixation of the syndesmosis. Malreduction of the syndesmosis would lead to abnormal pressure distribution on the ankle joint. Therefore, the flexible fixation might more accord with the physical movement of the syndesmosis. In this article, the biomechanical studies on syndesmosis are reviewed to provide the reference for proper treatment method for syndesmotic injury.