[Objective]To observe complications of tibial pilon fractures with Ⅲ leaves type plate and analysis of causes and prevention of complications.[Method]Fourty-two cases of the final pilon fractures were treated with Ⅲ leaves type plate from July 1999 to December 2003.There were 30 males and 12 females,the average age was 45.3 years(ranged,15～62 years),9 cases were open fracture and 33 cases were open fracture.According to the Ruedi-Allgower classification,there were 15 cases of type Ⅰ fracture,18 cases of type Ⅱ fracture and 9 cases of type Ⅲ fracture.[Result]Fourty-two cases were followed up for an average of 28 months(ranged,14～60 months),The time to fracture union averaged 16 weeks(ranged,11～26 weeks).The complications included infection in 6 cases,cases with severe traumatic arthritis and 3 cases with ankylosis.After evaluated according to the criteria of Bourne,there were 19 cases assessed as being excellent,17 as good and 2 as poor,the excellent and good rate was 85.7%.[Conclusion]Ⅲ leaves type plate is a good internal fixation for tibial pilon fractures,but the complications should be prevented.