The fracture of distal tibia bone is one of the most serious cases in the world, especially pilon fractures type. This is due to fact that the ankle joint involve soft tissue problems (cartilage and ligaments) and can cause to long-term disability. The treatment of pilon fractures are depending on several aspects where this may lead to complications. Different types of pilon fractures may not use similar treatment and the choices can be included several internal and external fixators. Therefore, this recent article is reviewing the principles of external fixator in treating pilon fractures. The use of this system with properly applied allows bony stability and increasing soft tissue care monitoring after fixation is achieved. The review discusses about the basic configurations of external fixator, stability of the external fixator and healing process. The findings will provide an additional information to medical doctors and engineers to decide the best configurations for patients associated with pilon fractures.

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