Aims: To determine the results of Òbiologic þxationÒ with a minimally invasive plating technique using a newly designed low proþle ÒScallopÒ plate in the treatment of pilon fractures. Methods: 17 patients were treated between 1999 and 2001 for a tibial plafond with a newly designed ultra-slim plate. Eleven (65%) were high-energy injuries, two were open. Staged open reduction and þxation of the þbular fracture and application of an External Fixator was performed in 12 cases. As soon as the soft tissues and swelling allowed, the articular surface was reconstructed and anatomically reduced, if necessary through an small incision, and the articular block was þxed to the diaphysis using a medially placed, percutaneously introduced ßat Scallop plate. Time to healing and complications were evaluated. Quality of the results and outcome were graded using the Ankle-Hindfoot-Scale. Results: All patients went on to bony union at an average time of 14.1 weeks. There were no plate failures or loss of þxation/ reduction. Two superþcial wound-healing problems resolved with local wound care. At an average FU of 17 months eight patients (47%) had an excellent, seven (41%) a fair and two (12%) a poor result. The average AHS was 86.1. Conclusions: Based on these initial results, it appears that a minimally invasive surgical technique using a new low proþle plate can decrease soft tissue problems while leading to fracture healing and obtaining results comparable with other more recent series. We believe that this new ÒScallop PlateÒ is appropriate for the treatment of pilon fractures and should be used in conjunction with a staged procedure in the acute trauma setting.