A Pilon fracture, which is defined as a comminuted intra-articular fracture of distal tibia, violates the articular region and the metaphysis with occasional extension into the diaphysis, and renders the bone difficult to restore to its anatomic shape. Now there is wide consensus that more aggressive surgical treatment is needed to fulfill better result in such complex fracture. The authors analized 22 cases of pilon fracture of distal tibia that treated by the prinicple of anatomical reduction, rigid internal fixation and early rehabilitation at the Department of Orthopaedic Surgery, Pohang St. Marys Hospital from March 1989 to October 1995. The average follow up period was 54 months(from 16 to 90 months). The results were as follows ; 1. We obtained bone union in all cases and average union period was 19 weeks(from 12 to 26 weeks). 2. The most frequent type of fractures was type III(12 cases . 55%) according to Ruedi and Allgower classification. 3. According to the clinical results that classified by the criteria of the Ovadia and Beals subjective evaluation classification, type I and II were excellent and good, and type III excellent in 5 cases, good in 4 cases, fair in 1 case and poor in 2 cases. 4. The most important variables that influenced in the clinical result were the type of fracture and severity of soft tisuue injury.