The principle of syndrome differentiation and prescribing herbal formula in the internal medicine of orthopedic injury is to apply eliminating and inducing methods such as eliminating blood stasis by catharsis, promoting circulation of qi and blood, dispelling heat from blood to stop bleeding and inducing resuscitation at the initial stage of injury when blood stasis is prominent. In the middle stage of the injury, when swelling and pain are reduced with minor blood stasis and fracture, mediation method is applied for new growth and to unite fracture. Common mediation methods are regulating the constructive system to alleviate pain, uniting broken bone and connecting soft tissues, and relaxing soft tissues and improving circulation. In the last stage of injury, deficiency is very common due to depletion of qi, blood and fluid. Tonifying methods such as supplementing qi and blood, tonifying spleen and stomach, and tonifying liver and kidney as well as warming the meridians to promote qi flow. Our department received a patient with complete smashed fracture between right tibia and fibula. Months after operation, the right ankle still had swelling, pain and stiffness. We applied syndrome differentiation of the three stages of the injury, and concluded the diagnosis as middle-late stage, qi stagnation and blood stasis. The treatment principle is to harmonize constructive system to promote growth and tonify liver and kidney with promoting circulation of qi and blood, and eliminating swelling and alleviating pain. The swelling, stiffness and pain were improved after treatment.