Objective:To discuss the different treatment,timing of surgery and the prevention of complications on Pilon fracture.Methods:37 patients and 41 sides tibia Pilon fracture between August 2001 and November 2007 were followed up.The average age was 37.4 years(range from 15 to 62 years).The mechanism of injury were fall in 25 cases ,traffic accident in 8 cases and other cause in 4 cases,14 cases (16 sides)were open fracture,23 cases (25 sides) were closed fracture,and 35 sides accompanied fibula fracture.About the tibia fracture,there were 20 sides fixation with plate,10 sides limited fixation with screw and Kirschner wire,5 sides with the external fixation apparatus and 6 sides had done arthrodesis.Results:The average period of follow-up was 52.3 months.According to Mazur's criterion,the result of the treatment was evaluated as excellent in 13 sides,good in 17 sides,fair in 7 sides and poor in 4 sides.After operation,complications included wound dehiscence in 13 cases,posttraumatic arthritis in 15 sides,varus of the ankle joint in 3 sides(>10°)and delayed union of tibia in 4 sides.Conclusions:There were a lot of factors to affect the prognosis of tibia Pilot fracture.It was very important to do operation with right method in timing of surgery.