【Abstract】 [Objective] To explore the clinical effect of minimally invasive percutaneous plate fixation under fixed retractor for type II and type III pilon fractures. [Method] A retrospective case-control study was used to analyze the clinical data of 48 patients with type II and type III pilon fractures admitted to the Department of Traumatology, Qingdao University Affiliated Hospital from March 2017 to April 2020, and divide them into reduction according to different surgical methods. Compare the differences in perioperative data, postoperative follow-up data, and imaging measurement results between the two groups of resetter group and routine group. [Results] The operations of both groups were successfully completed. In the perioperative data, the operation time, intraoperative blood loss, number of fluoroscopy, and incision length in the reductor group were less than or shorter than those in the conventional group, and the difference was statistically significant (p<0.05), while the two groups had incision healing grades and hospitalizations The time difference was not statistically significant (P>0.05); in the follow-up data, the walking time in the routine group was earlier than that in the reductor group, and the difference was statistically significant (p<0.05), but later in the comparison of the time of complete weight-bearing activities, the two groups Tend to be close, the difference is not statistically significant (P>0.05). In the comparison of VAS score, AOFAS score, and ROM score between the two groups, there was a significant improvement in the last follow-up than before the operation, the difference was statistically significant (p<0.05), but when the two groups were compared, there was no statistical difference Scientific significance (P>0.05); In the imaging measurement results, there was no significant difference in the Burwell-Charnley classification of fracture reduction quality and fracture healing time between the two groups (P>0.05). [Conclusion] For Type II and Type III pilon fractures, both minimally invasive percutaneous plate fixation with fixed retractor and conventional open reduction and internal fixation techniques can achieve satisfactory results, but fixed retractor with minimally invasive percutaneous plate Fixation has the advantages of short operation time, incision length, fracture, intraoperative fluoroscopy and less bleeding, and is worthy of clinical promotion.