Objective To study the effect of internal fixation in treating three-ankle fracture. Methods 48 cases of three-ankle fractures were treated with 1 /3 tubular plate or distal anatomical plate for open reduction and internal fixation,according to the order of the lateral malleolus-after ankle-medial malleolus. Results All patients were followed up for 6 ~ 24 months. According to AOFASO scoring criteria: excellent in 29 cases,good in 11,fair in 6,and poor in 2,and 83. 3% of patients were scored as good or excellent. Conclusions Open reduction and internal fixation for three-ankle fractures can restore the normal structure of the ankle,reconstruct the stability of the ankle,and the clinical efficacy is satisfactory.