A pilon fracture, which is defined as a comminuted intraarticular fracture of distal involve the articular surface and metaphysis with occasional extension in the diaphysis.

The management has been notoriously difficult due to the associated injury, intraarticular fracture, severe communition of distal tibia, joint incongruity and soft tissue trauma.

Most authors has reported good results after a surgical treatment by a principle of AO group treatment.

Rescently, Bone et all reports that ROM and outcomes of the severly comminuted or open fractures of the distal intraarticular tibia were very good in using the external fixator.

The result of treatment of 22 cases were analysed at the Department of Orthopedic Surgery, Dong-A University hospital from Mar. 1990 to Feb. 1993.

The results were as follows;

1. The incidence of pilon fracture is 8.3% of all ankle fracture treated during same period.

2. The most common cause of injury is fall down(63.3%).

3. The most frequent type is type 3 (54.6%).(by Rudei & Allgower)

4. The most common associated injury is compression fracture of spine and calcaneal fracture(4 cases).

5. There are eight cases open Pilon fracture(36.3%)

6. We had treated severe communited fracture and open fracture by using external fixator, we achived good ROM and outcomes.

7. The more accurate reduction, the better clinical result.

8. Complication of the Pilon fracutre were traumatic arthritis, non-union, malunion, wound int, etc.