An apparatus, comprising: an intramedullary rod configured to be received within an intramedullary canal of a fibula and to provide fixation of a fracture of the fibula, wherein the intramedullary rod comprises a first transverse opening, a second transverse opening, and a third transverse opening extending therethrough, wherein the first transverse opening and the second transverse opening are axially spaced, wherein the third transverse opening is disposed between the first transverse opening and the second transverse opening, wherein the third transverse opening is aligned with a passage extending transversely and completely through the fibula and an adjacent tibia; a first bone screw and a second bone screw configured to extend respectively through the first transverse opening and the second transverse opening of the intramedullary rod to secure the intramedullary rod to the fibula; a flexible elongate element configured to extend through the third transverse opening and the passage, wherein the flexible elongate element is configured to be tensioned to limit syndesmotic motion between the fibula and the tibia, and wherein the flexible element has flexibility to not completely prevent the syndesmotic motion; a fibula anchor coupled to a lateral end of the flexible elongate element and configured to be disposed proximate to the fibula; characterised in that the apparatus further comprises a tibia anchor coupled to a medial end of the flexible elongate element and configured to be in contact with a surface of the tibia, wherein the tibia anchor and the fibula anchor are configured to maintain tension on the flexible elongate element, wherein the tibia anchor comprises: an insertion configuration in which the tibia anchor is parallel to the flexible elongate element while the tibia anchor is moved through the third transverse opening and the passage; and an anchoring configuration in which in which the tibia anchor is angled related to the flexible elongate element while the tibia anchor in contact with the surface of the tibia. an intramedullary rod configured to be received within an intramedullary canal of a fibula and to provide fixation of a fracture of the fibula, wherein the intramedullary rod comprises a first transverse opening, a second transverse opening, and a third transverse opening extending therethrough, wherein the first transverse opening and the second transverse opening are axially spaced, wherein the third transverse opening is disposed between the first transverse opening and the second transverse opening, wherein the third transverse opening is aligned with a passage extending transversely and completely through the fibula and an adjacent tibia; a first bone screw and a second bone screw configured to extend respectively through the first transverse opening and the second transverse opening of the intramedullary rod to secure the intramedullary rod to the fibula; a flexible elongate element configured to extend through the third transverse opening and the passage, wherein the flexible elongate element is configured to be tensioned to limit syndesmotic motion between the fibula and the tibia, and wherein the flexible element has flexibility to not completely prevent the syndesmotic motion; a fibula anchor coupled to a lateral end of the flexible elongate element and configured to be disposed proximate to the fibula; characterised in that the apparatus further comprises a tibia anchor coupled to a medial end of the flexible elongate element and configured to be in contact with a surface of the tibia, wherein the tibia anchor and the fibula anchor are configured to maintain tension on the flexible elongate element, wherein the tibia anchor comprises: an insertion configuration in which the tibia anchor is parallel to the flexible elongate element while the tibia anchor is moved through the third transverse opening and the passage; and an anchoring configuration in which in which the tibia anchor is angled related to the flexible elongate element while the tibia anchor in contact with the surface of the tibia. an insertion configuration in which the tibia anchor is parallel to the flexible elongate element while the tibia anchor is moved through the third transverse opening and the passage; and an anchoring configuration in which in which the tibia anchor is angled related to the flexible elongate element while the tibia anchor in contact with the surface of the tibia.