The pilon fracture result from axial compression and rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displacement. It is managements are closed reduction and plaster immobilization, skeletal traction, fibular stabilization alone, limited open reduction and extemal fixation, primary arthrodesis, and even immediate amputation. Recently limited open reduction and external fixation has been proved to provide good clinical results for the severely comminuted or open pilon fractures. Authors reviewed 20 cases of the pilon fractures. Among them 10 cases were treated with limited open reduction and external fixation from October 1989 to January 1994. The results were as follows : 1. Age distribution was from 14 years to 77 years(mean ; 47 years). 2. Of the 20 cases, male were 14, and female were 6. 3. The cause of injury were tracffic accident in 10 cases, slip down in 6 and fall from a height in 4. 4. The most frequent type of fractures was type III(12 cases : 60%) according to Ruedi and Allgower classification. 5. Limited open reduction and external fixation(10 cases) has shown better results than classic open recduction and internal fixation for severely comminuted or open pilon fractures.