We have reviewed 15 cases of tibial pilon fractures who have been treated operatively from May, 1990 to May, 1995 at our hospital. 1. The fractures were classifed into Type I, I and III according to the system of Mast, Spiegel and Pappas and Type III were subdivided into Type A, B and C according to the system of Ruedi-Allgewer, Type I was 1 case(6.7%), Type II were 8(53.3%), Type IIIA were 2(13.3%), Type IIIB were 3(20%) and Type IIIC was 1 case(6.7%). 2. Type I, II and IIIA were treated with open reduction and internal fixation using screw or plate. 2 cases of Type IIIB were treated with open reduction and external fixation and 1 case was treated with plate. Type IIIC was treated with open reduction and external fixation. 3. Conclusively. we had good results with open reduction and internal fixation in Type I, II and IIIA. In Type IIIB, IIIC, if it was difficult to maintain of reduction with internal fixation due to severe bone loss, comminution and soft tissue injury, we could have good results with open reduction, bone graft and external fixation including ankle joint.