A pilon fracture, which is defined as a comminuted intraarticular 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. The best known treatment of the pilon fracture is, as recommended by A-O group. In the treatments of the fractures with severe comminution or with significant open soft tissue injury aggressive tries for internal fixation with plate and screws in the distal tibia will result in inevitable stripping of the soft tissue and the periosteum. Therefore, dangers of the delayed union, nonunion, soft tissue necrosis and infection will be increased. The authors treated 14 cases by the Ilizarov external fixation technique for treatment of pilon fracture of the tibia. The average duration of external fixation was thirteen weeks. The results were as follows. v1. Such techniques are especially useful in those injuries with extensive aricular communition and in the open pilon fracture with significant soft tissue compromise. 2. The average duration of external fixation was 13 weeks and the time to clinical union averaged 16.4 weeks. 3. In case of accurate reduction, the better clinical result was obtained.