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目的：对切开复位内固定术（ORIF）与手法复位（CMR）治疗踝关节骨折（AF）的临床有效性与安全性进行综合评价。方法选择本医院2011年10月-2012年10月接诊的98例AF患者，其中Lange-Hansen分型I 型30例，I I型36例，IV型32例。对其中49例患者采取ORIF治疗，为ORIF组；对另外49例患者采取CMR治疗，为CMR组。对比两组患者治疗后踝关节X片Leeds评分，4、6、12周骨折指端骨痂生长情况和住院时间及费用。结果两组疗效相比，ORIF组I 度损伤患者的优良率为100.0%（16/16），CMR组为92.9%（13/14），ORIF组I I度损伤患者的优良率为82.4%（14/17），CMR组为57.9%（11/19），ORIF组IV度损伤患者的优良率为75.0%（12/16），CMR组为43.8%（7/16），两组I度损伤患者疗效相比，差异不具有统计学意义，而II-IV度损伤患者疗效相比， ORIF组明显优于CMR组，且差异具有统计学意义（P＜0.05）；ORIF组4、6、12周骨痂生长评分明显低于CMR组，差异具有统计学意义（P＜0.05）；CMR组患者住院天数和治疗费用分别为（11.2±2.4）d和（5346.5±439.3）元，而ORIF组为（17.4±4.1）d和（16352.4±1252.3）元，CMR组明显少于ORIF组，且差异具有统计学意义（P＜0.05）。结论CMR治疗AF，骨痂生长情况好，且住院时间和住院费用均更少，但ORIF治疗时踝关节功能恢复明显更优，需要根据患者损伤程度选择合适的治疗方式。“,”Objective To comprehensive evaluate the efficacy and safety of Open Reduction and Internal Fixation(ORIF)and Closed Manipulative Reduction(CMR)on ankle fractures (AF). Methods 98 cases with AF in the hospital from October 2011 to October 2012 were selected, as for Lange-Hansen Typing ,30 cases were type I , 36 cases were type II, 32 cases were type IV. Of which 49 patients treated by ORIF,as the ORIF group; another 49 patients were treated by CMR,as the CMR group. Ankle X-rays Leeds score, 4,6,12 weeks finger fracture call us growth and hospitalization time and costs in two groups were recorded and compared after surgery. Results The excel ent rate of patients with I degree injury in ORIF group was 100.0% (16/16), and 92.9% (13/14) in CMR group, excel ent rate of patients with II degree injury in ORIF group 82.4% (14/17), and 57.9% (11/19) in CMR group, excel ent rate of patients with IV degree injury in ORIF group was 75.0% (12/16), and 43.8% (7/16) in CMR group, the difference of efficacy in patients with I degree injury in two groups was not statistically significant, and efficacy in patients with II-IV degree injury was higher in ORIF group than in CMR group, and the difference was statistical y significant (P<0.05); bone call us growth rates at 4,6,12 week significantly lower in ORIF group than in CMR group, the difference was statistically significant (P<0.05); hospitalization time and treatment costs in CMR group was (11.2±2.4) d and (5346.5±439.3) million, while (17.4±4.1) d and (16352.4±1252.3) million in the ORIF group, significantly less in CMR group than in ORIF group, and the difference was statistically significant (P<0.05). Conclusion Call us growth is better, and hospitalization time and costs are less when choose CMR to treat AF, but ORIF has a significantly better functional recovery of ankle, thus need to select the appropriate treatment of patients according to the degree of damage.