Abstract: OBJECTIV To investigate the distribution of pathogens isolated from open tibiofibular fracture patients with postoperative infection and observe the clinical effect of VSD combined with external fixation so as to provide guidance for clinical treatment. METHODS From Dec 2011 to Dec 2015, a total of 166 open tibiofibular fracture patients who had postoperative infection were enrolled in the study and were evenly divided into two groups according to digital talbe method. The combination group (83 cases) was treated with VSD combined with external fixation, while the conventional group was given external fixation combined with routine perfusion irrigation. The clinical data of all the enrolled patients were analyzed by clinicians before the treatment, the drug susceptibility testing was carried out, the specimens were collected twice for each patient within 3 hours, the routine culture was conducted, and the pure colonies were selected and identified by using bacterial identification system. RESULTS Totally 166 strains of pathogens were isolated from the 166 patients with open tibiofibular fracture, including 82 (49.40%) strains of gram-positive bacteria, 61 (36.75%) strains of gram-negative bacteria, and 23 (13.86%) strains of fungi. After the treatment, the time of control of infection of the combination group was (10.96±2.03d), significantly shorter than (22.39±1.17d) of the conventional group; the time of wound healing of the combination group was (21.82±11.39d), significantly shorter than (42.05±13.73d) of the conventional group; the time of fracture healing of the combination group was (6.26±1.08 m), significantly shorter than (10.54±3.39 m) of the conventional group; the recovery time of limbs of the combination group was (15.93±2.75 w), significantly shorter than (19.47±3.86 w) of the conventional group. The excellence rate of the combination group was significantil higher than that of the conventional group after the treatment, while the incidence rate of complications of the combination group was significantly lower than that of the conventional group (P<0.05). CONCLUSION The external fixation combined with VSD can achieve significant effect on treatment of the open tibiofibular fracture patients with postoperative infection and facilitate the recovery of the patients, however, it is necessary to grasp the surgical indications, debridement principles, fix the external fixators correctly, and choose effective antibiotics for combined treatment.