Objective To compare the healing effect of compound tibial and fibular fractures with two different fixation methods of external fixators (EF) and interlocking intramedullary nail ( INF). Methods Eighty-six cases of compound tibial and fibular fractures received different treatment, 36 cases in EF group and 50 cases in INF group. The difference between two groups was statistically analyzed according to WU Yue-song and XU Bo-cheng standard and Johner-Wruh score. Results All cases were followedup for 6-24 months,average (16.0 ± 2.4) months. The excellent and good rate were 80.6% (29/36) in EF group and 88.0%(44/50) in INF group respectively. There was no significant difference between two groups (Z =-1.103,P ＞0.05). Conclusions To the compound tibial and fibular fractures patients,INF can be considered as an effective method. It's an important therapy choice with EF to heal the compound tibial and fibular fractures.