Objective To explore the clinical effect between bridge locking anatomical plate with supported plate based four column in type Ⅲ Rüedi-Allgower Pilon fracture.Methods Retrospective study was performed on the clinical data of type Ⅲ Rüedi-Allgower Pilon fracture undergoing surgery. Patients were divided into two groups according to internal fixation. Some parameters including operation time, blood loss, and drainage, healing time, full burden time, functional score and pain score were analyzed. Results There was no significant difference between the operation time, blood loss and drainage between the two groups（t=0.37, P>0.05；t=0.71,P>0.05；t=0.24, P>0.05). The healing time and full burden time of experimental group was lower than control group significantly (t=1.56,P＜0.05；t=2.43, P＜0.05). For American Orthopaedic Food and Ankle Society(AOFAS) score and visual analogue score(VAS) in postoperative 1 month, there was no significant difference between the two groups. For AOFAS score and VAS score in experimental group was lower than control group after 3 months (P＜0.05). There was no significant difference between two groups in reduction quality Burwell-Charnley score and complication between two groups. Conclusion Supported plate based four column could improve the life quality of patietns with Pilon fracture, which is worth to recommed in clinical application.