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OBJECTIVE To explore clinical effect of delayed internal fixation through anteromedial and posterolateral approach of ankle joint in treating Pilon fracture combined with fibula fracture. METHODS From December 2016 to December 2018, 18 patients with Pilon and fibula fracture treated by internal fixation through anteromedial and posterolateral approach of ankle joint with three plates, including 12 males and 6 females, aged from 38 to 51 years old with an average of (44.00±3.45) years old. According to classification of Rüedi and Allgöwer