Objective To assess the clinical effects of blocking screws in the internal fixation with intermedullary nails on distal tibial fractures. Methods The clinical data of 55 cases of distal tibial fractures treated by intermedullary nails were retrospectively studied. These cases were divided into two groups: 24 cases who were treated by intramedullary nails simply and 31 cases who were treated by blocking screws with intramedullary nails. The clinical data of two groups were statistically analyzed. Results These cases were followed up for 6 to 15 months, with an average of 9 months. The group of blocking screws with intramedullary nails got shorter operation duration ( t=2.57, P<0.05). There was no statistically significant difference in the rate of re-dislocation between the two groups( P>0.05)There was no statistically significant difference in the fracture healing time between the two groups( t=0.606, P>0.05).The group of blocking screws with intramedullary nails got higher grade of ankle joint function( χ²=7.78, P<0.05).Conclusions Blocking screw technique has the effects of improving and maintaining the fracture reduction in the internal fixation with intramedullary nails in distal tibial fractures, and strengthens the stability of fractures after internal fixation with intermedullary nails.It also provides benefits for limb function recovery.