Objective To explore the diagnosis and surgical treatment of tarsometatarsal joint complex injuries. Methods Between January 2000 and October 2009, 24 cases of tarsometatarsal joint complex injuries were treated. There were 14 males and 10 females with an average age of 38 years (range, 21-65 years). Injury was caused by a machine in 8 cases,by traffic accident in 12 cases, and by fall ing from height in 4 cases. All fractures were closed. The time from injury tohospital ization was 2-17 hours (5 hours on average). Open reduction and internal fixation with screw were performed. Results Incision healed by first intention in other patients except 1 patient who had effusion at incision. Twenty-three cases were followed up 12-47 months with an average of 23 months. X-ray films showed that all fractures healed after 9-15 weeks of operation (13 weeks on average). No compl ication was found, such as osteofacial compartment sydrome, nonunion infection, loosening or breakage of the internal fixator. According to Maryland scoring, the results were excellent in 7 cases, good in 8 cases, fair in 5 cases, and poor in 3 cases with an excellent and good rate of 65.2%. Conclusion Anatomical reduction and stable fixation are important for satisfying results in treating tarsometatarsal joint complex injuries.