Abstract: Objective：To explore the clinical efficacy of open reduction and internal fixation to trimalleolar fracture. Methods：26 cases of trimalleolar fracture were collected and performed opening reduction and internal fixation. There were 15 males and 11 females. Lateral malleolus fracture used distal anatomical plate fixation， medial malleolus fracture used cannulated screws or wire tension band fixation， posterior malleolus fracture used cannulated screws or plate and screw fixation. Results：All cases were followed up for 12-18 months， All fractures healed，no wound infection，traumatic arthritis，joint deformities and other complications. Joint function were excellent in 18 cases，good in 6 cases，fair in 2 cases and bad in 0 cases. Conclusion：After trimalleolar fracture，full preoperative preparation and accurate open reduction and internal fixation，with effectively function exercise，can obtain good therapeutic effect.