[Objective] To compare the clinical outcomes of three kinds of flaps in repairing soft tissue defect complicated with openankle joint fracture and dislocation. [Methods] A retrospective study was conducted on 51 patients who received surgical treatment for softtissue defect complicated with open ankle fracture and dislocation in our department from January 2015 to February 2021. According todoctor-patient communication, 29 cases received perforating artery perforator flap (PAPF), 15 cases received sural neurocutaneous flap(SNCF), and 7 cased underwent anterolateral thigh flaps (ALTF). The documents of perioperative period and follow-up were comparedamong the three groups. [Results] The ALTF group proved significantly greater than the PAPF and SNCF in terms of operation time of[(165.5±26.4) min vs (125.3±13.8) min vs (120.8±11.3) min, P＜0.001], flap area [(62.7±6.7) cm2 vs (55.3±6.4) cm2 vs (54.9±8.2) cm2, P=0.038], intraoperative blood loss [(298.6±30.7) ml vs (238.9±38.9) ml vs (229.6±30.7) ml, P＜0.001], whereas there were no statistical signifi-cances between PAPF and SNCF groups in abovesaid items (P＞0.05). However, there were no significant differences among the threegroups in terms of the time interval of two stage operations, the closure form of donor area, the healing of donor area, and the hospital stay(P＞0.05). All the patients in the 3 groups were followed up for a mean of (14.7±2.0) months, and there was no significant difference in thetime to resume full weight-bearing activity among the three groups (P＞0.05). The VAS score, ankle dorsal-plantar flexion ROM, AOFASscore and donor scar score were significantly improved over time (P＜0.05). The PAPF group got significant improvement in sensory functionwith time (P＜0.05), while the SNCF group and ALTF group had it remained unchanged (P＞0.05). At the last follow-up, the ankle dorsalplantarflexion ROM in PAPF and SNCF groups was significantly better than that in ALTF group [(62.1±5.1)° vs (61.7±6.2)° vs (54.9±5.3)°,P=0.010]. The PAPF and ALTF group were significantly better than SNCF in terms of sensory function [excellent/good/fair/poor: (17/7/3/2)vs (4/1/1/1) vs (2/3/7/3), P=0.046], and the donor scar score [(3.9±0.9) vs (4.2±1.3) vs (5.1± 0.9), P＜0.001]. [Conclusion] PAPF retrogradeskin flap for the repairing soft tissue defect complicated with open ankle fracture and dislocation has advantages of few complications, moresatisfactory flap appearance and better sensory function recovery.