Objective To discuss the effects of triangle limited fixation by Russian external fixator for proximal and distal tibiofibular fractures. Methods From December 2005 to December 2007, 54 patients with tibiofibular fractures were managed with close reduction and triangle limited fixation by Russian external fixator. They were 48 males and 6 females, aged from 18 to 54 years (average, 34 years). By AO classification, there were two cases of type 41-C3 (one complicated with type 43-B2 and one with type 43-A3), 17 cases of 42-A, 13 cases of 42-B, 12 cases of 42-C, 5 cases of 43-B, and 5 cases of 43-C.Twenty-six cases were open injury (by Gustilo classification, type Ⅱ in 13, type ⅢA in 10, type ⅢC in 3),and 28 closed injury (by Tscherne classification, grade Ⅰ in 8 and grade Ⅱ in 20). Results Follow-ups of 50 patients revealed that the fractures healed from 2 to 6 months (average, 3 months). Swelling subsided in just one week in the 28 patients with close injury. Of the 26 patients with open injury, 24 obtained primary healing of wounds, one obtained wound healing 4 weeks after changes of dressing, and one suffered amputation. No malfunctions were found in this group. One case had nonunion which was healed after change to single-ann external fixation. Conclusion Triangle limited fixation by Russian external fixator can be applied in the treatment of complex tibiofibular fractures.