Report about 33 patients with fractures of the pilon tibialis. Most of the fractures were treated surgically. In half of all cases severe destructions of the joint were found, the bone was broken into pieces. In eight patients compound fractures were seen; twelve fractures were observed in polytraumatized patients. In 18 patients a follow-up could be done. Only in seven cases the results were good. In six cases the outcome was satisfying, in five cases the results were bad. The reasons for unsatisfying late results are discussed.