We treated 60 patients with type III Pilon fractures (Ruedi and Allgower Classification) between 1996 and 2005. The fractures were distracted and then fixed with an Ilizarov circular ring fixator, without the use of open surgery. No internal fixation was used for the tibia or fibula. No bone grafting was performed.

The average time from injury to frame application was four days. The patient stayed ib frame for a mean time of 15 weeks. No second operative procedure was needed. All cases united in good alignment.

The patients were reviewed from ten years to nine months after frame removal. Four separate evaluations were performed (functional, objective, radiological and an SF-36). The function and the range of movement were better than the radiological assessment suggested.

This method of treatment gives better results with fewer complications than open surgery with internal fixation