In this prospective study, 30 patients (28 men and 2 women) with open ankle fractures were treated with early debridement and immediate stable internal fixation after anatomical reduction to achieve better functional results after early mobilization. The procedure was performed an average of 8 hours (range, 6–15 hours) after injury. According to the classification system of Gustilo and Anderson, 11 fractures (37%) were grade I, 12 (40%) were grade II, 5 (17%) were grade IIIA, and 2 (7%) were grade IIIB. Six complications occurred: four patients had superficial skin necrosis and two had loss of reduction, resulting in residual ankle stiffness. Twenty patients had excellent results, eight had good results, and two had fair results according to the modified criteria of Ketenjian and Shelton. We found that immediate debridement, anatomical reduction, and internal fixation of open ankle fractures leads to better functional results, especially in grade I and grade II injuries. (J Am Podiatr Med Assoc 96(2): 120–124, 2006)