Objective To analyze the clinical curative effect of three different surgical methods for the treatment of traumatic ankle arthritis and provide a theoretical basis for clinical treatment. Methods 90 patients with traumatic ankle arthritis admitted to our hospital from January 2011 to April 2013 were selected and divided into 3 groups according to different treatment methods (Each group of 30 cases). The patients were treated with artificial total ankle replacement (ankle replacement group), ankle arthrodesis external fixation (ankle arthrodesis external fixation group) and ankle joint fusion internal fixation (ankle arthrodesis group). The mean followup time was (33.14±3.26) months in the ankle fusedexternal fixation group and (36.78±4.57) months in the ankle arthrodesis group. The ankle hindfoot score, the postoperative quality of life improvement and the early clinical curative effect of the three groups were observed before and after operation. Results〓No significant difference was detected in age, sex, followup time, body mass index (BMI), preoperative activity and other data of three groups (P>0.05), but the activity of ankle joint replacement group significantly improved (P<0.05). No difference was detected in the scores of AOFAS between the three groups (P>0.05). The postoperative anklehindfoot score of AOFAS increased in all three groups. The ankle hindfoot score of the ankle arthroplasty group was significantly higher than that of the ankle arthrodesis group (P<0.05). No significant difference was detected in anklehindfoot score between the ankle fusion and the ankle joint fixation group (P>0.05). There was no significant difference in SF-36 score between the three groups before operation (P> 0.05). The SF-36 scores of the three groups after operation were all increased, but the SF-36 score of the ankle joint replacement group was significantly higher than that of the ankle arthrodesis group (P<0.05). No significant difference was detected in the score of SF-36 between the anklefixation group and the anklejoint fusion group (P> 0.05), but the traumatic ankle was significantly lower in the ankle joint fixation group and the ankle joint fusion and internal fixation group. No significant difference was detected in SF36 score between the ankle fusion and the ankle fusion fixation group (P> 0.05). There were some complications after arthritis, including: nonunion, loosening of the prosthesis, shallow deep infection, poor alignment and so on. The complication rate in the ankle replacement group was 20.00%. The incidence rate of complications in the ankle arthrodesis group was 26.67%, and the incidence of complications in the ankle arthrodesis group was 26.67%. No difference was detected in the incidence of complications between the three groups (P>0.05). Conclusion The total ankle replacement in patients with traumatic ankle arthritis treat better than ankle arthrodesis curative effect, which can quickly improve the quality of life of patients. There is no increase in the incidence of postoperative complications, worthy of promotion in clinical use.