We describe the results of treatment and complication of open tibial fractures in 44 children. There were 30 males and 14 females with an average age of the 6.7 years(range 3~2 years). The mean follow up period was 15 months(range 1.4~28month). According to the classification of Gustilo et al, Type I were 17 cases, Type II were 13 cases, Type IIIA were 9 cases and Type IIIB were 5 cases. All patient received tetanus prophylaxis, and systemic thirty-four with minimal soft tissue injury were closed primarily. The other 10 were initially left open; of these, 7 wounds were allowed to heal secondarily and 3 larger wounds required split skin grafts. The average time to healing of the fracture was 12.9weeks(range 6.9~22.4weeks). The complication included superficial infection(7%), malunion(5%), delayed union(2%), synostosis(2%), and leg length discrepancy(5%): these incidences are similar to those reported in adult. The osteomyelitis, compartment syndrome, and vascular injury didn't developed at any case. The K-wire fixation of open tibia fractures of the childrens is very useful to prevent the displacement and to care for the openwound without the risk of deep infection.