Aims: The evaluation of indications and results of the treatment of C fractures (according to AO) of the distal tibia with hybrid external þxation. Method: Between 1998–2001 thirty-one patients (22 men and 9 women), all available to follow-up, with 31 tibial pilon fractures were managed with hybrid external þxation. Mean follow-up time was 18 months and mean age 35 years (17–76). Seven were open fractures. Closed reduction (ligamentotaxis) and application of hybrid external þxation was done in 22 cases, while in 9 patients minimal open reduction, use of autologous bone grafts and minimal additional internal þxation was necessary. Mobilization of the ankle started at the 3rd postoperative day. The average time of healing was 4.2 months. Final evaluation was done according to evaluation criteria proposed by P. Tornetta III. Results: Fourteen patients (87%) had good and excellent, 2 (6.4%) fair and 2 (6.4%) poor. Complications were 1 valgus deformity > 8û, 1 nonunion, and 4 pin tract infections treated with p.o. antibiotics. Conclusions: Use of hybrid external þxation in C fractures allows anatomic reduction of the fragments with minimal invasion and immediate mobilization of the ankle join and early weight bearing. Open reduction is minimal and seldom needed. Pin site infection could occur.