Tibia pilon fractures are one of the hot topics of orthopaedics and traumatology with current need for the new approach, technique, and the implant. Factors that surgeon can change are: anatomical reconstruction of joint surface, obtaining anatomical joint alignment and orientation, and obtaining stable fixation allowing early pain free active motion. Above mentioned goals can primarily be achieved with perfect fracture characterization, thorough operative planning and procedures that do not further increase the current soft tissue injury. Current orthopedic literature supports staged surgery for pilon fractures with advanced soft tissue injury. Although the choice of implant is not that much important, having different sizes and types of implants in the operating theater may decrease unwanted surprises. Anatomical dissection on cadavers would be very helpful to improve knowledge and skills necessary for good outcomes in these complex injuries.