Objective 　To investigate therapeutic effect of single incision and surgical methods for treatment of open reduction with internal fixation (ORIF) fractures of the distal tibia and fibula.　Methods  August 2012 - August 2014 for treatment of single incision method by ORIF fractures of the distal tibia and fibula in 40 patients, including 34 cases of closed fractures, 6 cases of open fracture. 　Results　After a mean follow-up of 18 months, 40 patients were found to have fracture healed as expected and have primary closure of incision. Skin incision in 3 cases had developed superficial dry necrosis in the margin. The necrosis turned to scar after dressing change and fall off naturally without infection. Four patients developed manifestations of injury ofthe superficial peroneal nerve probably due to intraoperative traction, but natural recovery followed after 2~3 months. According to the standard Merchant function evaluation: the efficacy was excellent in 28 cases, good in 8 cases, poor in 4 cases.  The excellent and good rate was 90%.　Conclusion　Single incision ORIF of distal tibia fracture damage does not affect fracture healing. The soft tissue coverage and blood supply are better than the traditional two incisions, thus reducing the risk of infections and necrosis of the calf skin and soft tissue.  It is an alternative surgical approach.