To statistically analyze the advantages of distraction osteogenesis in combination with free flap in the treatment of tibial open fracture with bone and soft tissue defect.

Twenty patients with tibial open fracture with bone and soft tissue defect were treated by distraction osteogenesis with or without flap. Patients were followed up for a minimum of 12 months and retrospectively analyzed, for the admission period, the out patient follow-up period, and the intravenous antibiotic period, and distraction consolidation indices were determined.

Those treated with free flap showed statistically significance shorter antibiotic period, admission period, and distraction consolidation indices.

Free flap and distraction osteogenesis with an Ilizarov external fixator has many advantages for treating tibial open fracture with bone and soft tissue defect.