PURPOSE: To analyze the clinical features and treatment results of the tibial segmental fractures with the interlocking nailing. To compare the results between the segmental fractures with (Group I) or without (Group II) involving proximal portion of the tibia. MATERIALS AND METHODS: We analyzed 16 patients, 16 cases of the tibial segmental fractures treated with the interlocking nailing between April 1993 and November 1998. RESULTS: We obtained solid bone union for all cases and relatively good clinical results. The average bone union time was 20.6 weeks. The functional results were excellent in 7 cases, good in 6 cases and fair in 3 cases. There were 8 cases of malunion. The comparison between Group I and Group II revealed no remarkable differences for bone union time, functional results and complications. But the tendency of the malunion was more higher in Group I. CONCLUSION: For segmental tibial fractures, interlocking nailing showed good clinical results. We propose that open reduction and internal fixation should be done before interlocking nailing of the fractures involving proximal portion of the tibia.