PURPOSE: To evaluate and compare the outcome in fracture of distal tibial metaphyseal fractures involving ankle joint and not involving the ankle joint treated by interlocking imtramedullary nailing. MATERIALS AND METHODS: Twenty six cases of distal tibial metaphyseal fractures treated by interlocking intramedullary nailing whom were able to follow up for more one year were selected and 10 cases involved ankle joint and the rest 16 cases did not. In all cases, more than 2 distal locking screws were inserted after reaming for the nailing, and cannulated screws or K-wires fixation were inserted for 8 cases of fractures involving ankle joint out of 10. We analyzed preoperative fracture type, union time, function of joint, and complications at final follow up. RESULTS: According to Robinson's classification for distal tibial metaphyseal fractures, there were 9 cases of type I, 7 of 2A, 4 of 2B, 6 of 2C. Union time taken for distal tibial fractures involving ankle were average of 17 weeks (12~20 weeks) and for the fractures not involving ankle joint were average of 19 weeks (12~28 weeks). Klemm and Borner's functional evaluation showed above good in 8 cases (80%) of fracture involving ankle joint and 13 cases (81%) of fracture not involving the ankle joint, and functional evaluation did not show significant differences as well as the complication rate in both group. CONCLUSION: Interlocking intramedullary nailing is one of the effective methods for treatment of distal tibial metaphyseal fracture involving articular surface of the ankle.