Closed reduction and internal fixation with percutaneous cannulated screws was performed on seven-patients with closed pilon fractures. The mean follow-up was 30.6 months. They were assessed using a subjective scoring system. The average score was 90.8/100. This method of fixation avoids extensive soft tissue dissection and gives excellent results. To our knowledge, this method of closed reduction and stabilisation of pilon fractures solely by percutaneously inserted cannulated screws has not been previously reported. (C) 2003 Elsevier Ltd. All rights reserved.