Intraarticular fractures of the distal tibia, the so-called pilon tibial fracture, usually resultfrom a torsional injury, a motor vehicle accident, or a fall from a height. The management of these fractures has been notoriously difficult due to the comminution of the distal tibia, articular incongruity, and asscociat ed soft-tissue trauma. The best results of treatment reported for this fracture, have followed early open reduction and rigid internal fixation to restore length, recon struction of the plafond, primary cancellous bone-grafting, butress plate on tibia, early motion and prolonged non weight-bearing. The purpose of this study was to examine the experience of the Pusan Paik Hospital between 1986 and 1991 as it relates to the treatment of 20 pilon fractures and to correlates the Clinical fesults with fracture type. They were followed post-operatively for an average of 22.3 months. The results were as follows 1. The most frequent type of the fraEture was type III according to Ruedl and Allgowe Classification. 2. Open reduction and internal fixation in cases type II & III has showed better resulis than those treated conservatively. 3. The fibula fracture fixed internally with a plate first often makes re construction of the distal tlbia easier. 4. The most often complication was the ankle joint pain.