〔Abstract〕 Objective To analyze the effect of surgical internal fixation and rehabilitation in the treatment of complex ankle fractures. Methods 50 patients with complex ankle fractures in Loudi Central Hospital from February 2019 to February 2020 were randomly divided into two groups with 25 patients in each group. The patients in the control group were treated with conservative external fixation, and the patients in the observation group were treated with surgical internal fixation. The hospitalization time, excellent and good treatment rate, Mazur score of ankle function, quality of life index score and complication rate were compared between the two groups. Results The hospitalization time of the observation group was (9.56 ± 1.23) d, which was shorter than that of the control group (11.56 ± 1.27) d, and the difference was statistically significant (P < 0.05) . Before treatment, there was no significant difference in Mazur score of ankle function between the two groups (P > 0.05); After treatment, the Mazur score in the observation group was significantly higher than that in the control group (P < 0.05) . The rate of excellent and good treatment in the observation group was 100.00% , which was significantly higher than 76.00% of the control group (P < 0.05). Before treatment, there was no significant difference in the scores of various life indexes between the two groups (P > 0.05); After treatment, the scores of various life indexes in the observation group were significantly higher than those in the control group (P < 0.05). The incidence of complications in the observation group was 0.00%, significantly lower than 16.00% in the control group (P < 0.05). Conclusion The effect of surgical internal fixation and rehabilitation treatment of complex ankle fracture is definite, which can better restore joint function and shorten rehabilitation time.