This is the first monograph on fractures of the distal lower leg segment, particularly the intra-articular so-called pilon-tibial fractures. These have never been discussed in this way before due to their rarity and complexity. The classification, surgical therapy, and prognosis are also presented. Following a practice-oriented anatomical introduction, the classification is developed and explained based on the diverse case material from the AO documentation center and extensive personal experiences. This closely follows the "AO Classification of Fractures" published by M.E. Müller et al. in 1987. The very specific problem of articular impression at this location is addressed in detail. This is followed by a summary of the history of these injuries and an overview of previous publications. Indication, Te.