Objective To compare the clinical effect of external surgical approach open reduction & internal fixation(ORIF) and finite section internal fixation assisted external fixation in fixed frame for distal tibial fracture. Methods To apply two methods for distal tibial fracture with 32 cases in each. Results The operative time、intra-operative and post-operation on blood loss, the clinical fracture union and clinical complications were compared between two groups, the difference was not significant(P>0.05). Conclusions According to different pathological type,different operation methods were selected can get satisfactory effect.