Abstract： Objective To investigate whether hyperbaric oxygen preconditioning (HBOP) could decrease the incidence of postoperative complications in patients with distal tibiofibular fracture.Methods Two hundred and eighty-seven cases of distal tibiofibular open fracture admitted into the Zhongshan Hospital Affiliated to Fudan University for treatment from January 2004 to March 2013 were randomly divided into 2 groups:the hyperbaric oxygen preconditioning (HBOP) group(n =149)and the control group(n =138).On the basis of routine therapy prior to internal fixation,the HBOP group was administered with HBO therapy,while the control group was left there without HBO therapy.All the patents had 12-26 months of medical follow-ups to assess the results of different treatment.Then,the incidence of postoperative complications and functional recovery level were compared between the 2 groups.Results The incidence of postoperative complications in the HBOP group was obviously lower than that in the control group (P ＜ 0.05).And functional recovery level in the patients of the HBOP group was significantly superior to that of the control group,and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ O.05).Conclusions HBO preconditioning before surgical treatment of the patients with distal tibiofibular fracture could effectively decrease the incidence of postoperative complications and improve their functional recovery level.