Abstract：Objective To compare the accuracy of two fluoroscopic methods for Volkmann fracture with screw internal fixationTo explore the reliability and significance of the use of screw axial fluoroscopy to avoid the entry of screw into the posterior tibiofibular joint when treating the Volkmann fracture. Methods In the retrospective study 55 Volkmann fracture patients from Jul.2015 to Jul.2020 were included. According to different projection methods, they were divided into two groups：21 patients of screw axial projection group used screw axial method combined with ankle joint AP⪫ In the 34 patients of traditional experience projection group, the ankle joint AP&LAT and other single or combined position were used. The number of C-arm projections, duration of surgery, amount of bleeding, and accuracy were compared be tween the two groups. Result In the axial projection group, the duration of operation was(2.49?0.52)h , the amount of bleeding was(65.71?26.19) mL, and the number of C-arm projections was(22.57?2.66) times. In the traditional experience group, the operation time was(2.46?0.11) h , the bleeding volume was(70.88?35.11) mL and the number of projections was(1.5±0.6) times. There were no significant difference between two groups(P＞0.05). But the accuracy rate between two groups were significantly different, while 100% in the screw axial group and 79.4% in the traditional experience group. Conclusion The screw axial fluoroscopy is a safe and reliable method for evaluating the nail placement of Volkmann fracture.