Abstract: Objective:To compare the clinical efficacy of emergency and selective operation in the treatment of Pilon fracture for providing the basis of clinical operation.Methods:One hundred and thirty-eight patients with Pilon fractures were treated with emergency or selective operation from Feb.2005 to Mar.2011.Fourty-nine patients were treated with emergency operation within 12 hours after injury,89 patients were treated with selective operation at 7 days after injury.The operation time,blood loss,length of stay,hospitalization expense,postoperative complication,ankle jiont functional recovery of two groups were compared.Results:All patients were followed up for 9 to 36 months.The operation time,length of stay and hospitalization expense in emergency operation group were significantly less than those in selective operation group(P0.01),but its blood loss was more.There were not statistically significant differences in wound infection and necrosis,lower limb deep vein thrombus,the long-term complications(such as nonunion or delayed union of fracture),osteoarthritis and the incidence of ankle joint stiffness between the two groups(P0.05).The Mazur scores of ankle joint function in two groups had no statistically significant difference in 22 months after operation(P0.05).Conclusions:The postoperative complication incidence of emergency operation in the treatment of Pilon fracture is not higher than that in selective operation,which can shorten the length of stay,decrease the hospitalization expense and promote early functional rehabilitation.