Objective To compare curative effect of tibiofibular fractures treated by external fixation device and interlocking intramedullary nail.Methods A total of 121 patients with tibiofibular fractures were included in the study and were divided into external fixator group (56 patients) and interlocking intramedullary nail group (65 patients),according to diverse surgical approaches.The two groups were compared in indices of postoperative good-excellent rate,intraoperative blood loss,operation time,subsided time of postoperative swelling,hospital stay,fracture healing time,time of fixation removal and incidence of postoperative complications.Results The postoperative excellence rate in external fixator group and interlocking intramedullary nail group was 88％ and 89％,respectively (P ＞ 0.05).Compared with interlocking intramedullary nail group,the intraoperative blood loss was reduced more in external fixator group,with more evidently shortened operation time,subsided time of postoperative swelling and hospital stay (P ＜ 0.01).Fracture healing time and time of fixation removal,however,were significantly shorter in the interlocking intramedullary nail group than those in the external fixator group (P ＜ 0.01).Incidence of postoperative complications was 11％ in the external fixator group and 28％ in the interlocking intramedullary nail group (P ＜0.05).Conclusions External fixation device and interlocking intramedullary nail are both effective in treatment of tibial and fibular fractures.External fixation device with less damage to tissue is relatively more helpful to postoperative recovery.On the contrary,the interlocking intramedullary nail is relatively more conducive to fracture healing.