Objective To observe the differences in efficacy on treatment of fractures of the middle and lower 1/3 of the tibiofibula between cribriform splints plus electroacupuncture, warming needle and moxibustion only, and external fixation with traditional splints pius the administration of an herbal formula. Clinical efficacy and the effects on serum bone morphogenic protein -7 (BMP- 7) and endothelin-l(ET-1) were both measured. Method 600 patients with fractures of the middle and lower 1/3 of the tibiofibula were randomly divided into three groups according to andome number table: splint with electroacupuncture (group A}, warm needling moxibustion group (group B) and splint with traditional Chinese medicine herb (Group C). Cribriform splints with electroacupuncture were used in group A, warming needling therapy were adopted in group B, and traditional splints with external fixation were used along with oral administration of musk bone capsules (麝香接骨胶囊) in group C. Clinical results for the three groups were compared, and ELISA method was used to detect the serum BMP-7 and ET-1 of patients in the three groups before and after treatment. Results Group A was better than group B and group C in terms of clinical healing days and delayed healing status (P〈0.05). After treatment, group A was also better than the other two groups in the improvement of BMP-7 and ET-1 (P〈0.05). Conclusion Electroacupuncture treatment with cribriform splints for fractures of the middle and lower 1/3 of the tibiofibula resulted in significantly shorter clinical healing time, and lower incidence of delayed healing compared to warm needling or splints with a traditional Chinese herbal formula. Its mechanism may be associated with greater regulation of serum BMP-7 and ET-1 through electroacupuncture.