Abstract：Objective To observe the clinical effect of different types of external fixation in the treatment of tibia and fibula with Gustilo Ⅲ fracture.Methods From January 2012 to 2015 January，22 cases of Gustilo-type Ⅲ fractures with bone defects were treated in our hospital.All patients wounds were thoroughly debrided and fractures were given a semi-circular external fixation.Residual woundsweretreated with skin flap，skin grafting，local soft tissue.Ilizarov circular external fixators were used to fix fracture.Osteotomy and bone lengthening wereused to treat bone defect.Results All of the 22 patients were followed up.The follow-up time was 16 to 36 months (average 20 months).17 patients withbone lengtheninggot boneunionwithoutoperation.In 5 cases of patients with malalignment，external fixationwas removed andpatients underwent bone grafting and plate fixation.All the patients gotbone union.According to the Johner-Wruhs score，there were 18 cases of excellent，3 cases of goodand poor in 1 cases，the excellent and good rate was 95.5％.Conclusion External fixationcan effectively protect the soft tissue blood supply and reduce the secondary injury，which isconsistent with trauma control theory.It can alsopromote the recovery of limbs and functional reconstructioninbone defect of tibia and fibula of Gustilo Ⅲ.It is an ideal fixation method for the treatment of Gustilo Ⅲ fractures.
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