The treatment of very distal tibial (pilon) fractures remains one of the great challenges for the orthopaedic traumatologist. It is essential that the treating surgeon have a proper understanding of the fracture, the soft tissue injury, and the skills to deal with these often-complicated injuries to minimize the risk of complications that can occur after these often higher energy injuries. Bone stability can be achieved with both circular ring fixation and plating, and both can yield good results in experienced hands. This debate considers the advantages and disadvantages of each technique.