Objective To investigate the approaches and effect of Ilizarov external fixators combined with limited operation in treatment of posttraumatic clubfoot in children.Methods The study involved 40 cases (43 feet) of posttraumatic clubfoot treated with Ilizarov external fixators combined with limited operation including soft-tissue releases (26 cases,28 feet) or osteotomies (14 cases,15 feet)from January 2006 to June 2012.Scoring system of intemational clubfoot study group (ICFSG) including aspects of functional assessment (36 points),morphology (12 points) and radiological assessment (12points) were employed before and after surgery.Results All the cases were available to the follow-up of 0.5-6 years.ICFSG score was excellent in 28 feet,good in 10,fair in four and poor in one foot,with excellent-good rate of 88%.This suggested the good correction of posttraumatic clubfoot,satisfactory weight-bearing exercise and a low relapse rate.Conclusions Conservative open operation brings large trauma and poor results in treatment of posttraumatic clubfeet in children,while Ilizarov invasive distraction technique is probable to offset those weak points.Therefore,Ilizarov external fixators combined with limited operation is an effective treatment.