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The cases of one hundred and forty-two patients with 145 fractures of the ankle joint that involved the tibial plafond were reviewed. The fractures were classified into five types according to the severity of the injury. The methods of treatment were divided into two groups: open reduction and rigid internal fixation by the AO technique, and other methods. The most important variables that affected the final clinical result were the type of fracture, the method of treatment, and the quality of the reduction (p less than or equal to 0.05). The best results were obtained by rigid open reduction and internal fixation, with which 65 per cent of the more severe type-III, IV, and V fractures obtained a good or excellent result.