PURPOSE: The purpose of this study was to analyze the associated injury, difficulties in management and complications with surgery, and to suggest the guideline according to the severity and type of injury in the management of both tibia fractures. MATERIAL AND METHOD: We analyzed 12 patients, 8 men and 4 women and their age was 43.4 years old in average. The cause of injury was traffic accident in 10, autobike in 1 and farm machine injury in 1 case. There were both open tibia fracture in 6, one side open fracture in 2 and both closed fracture in 4 cases. We analyzed the average interval from injury to operation, duration of hospitalization, duration of both side bone union and complications. RESULTS: In both open tibia fracture, the average interval from injury to operation was 12.5 days, average duration of hospitalization was 3.2 months, and average duration of bone union was 14.5 months. In one side open fracture, the average interval to operation was 25 days, average duration of hospitalization was 3.75 months, and average duration of bone union was 8.7 months. In both closed fracture, the average interval to operation was 15 days, average duration of hospitalization was 1.92 months, and average duration of bone union was 4.8 months. CONCLUSION: Both tibia fractures were caused by high energy and also associated with multiple injury, and fracture stability and soft tissue damage should be evaluated thoroughly before surgery. Anatomical reduction and rigid fixation should be necessary to reduce the post-surgical complications.