In contrast to type I and II open fractures, type III open fractures have a bad prognosis due to massive soft tissue damages, compromised vascularity, severe wound contamination and marked fracture instability. Management of type III open fractures has long been one of the most difficult problem facing the orthopedic surgeon. The authors reviewed 90 cases of type III open fracture in long bones, treated at the department of orthopedic surgery, Busan Paik Hospiatal from July, 1980 to December, 1990. The results were as follows. 1. Bacterial cultures carried out from the open wounds in 49 patients yielded 39 bacterial isolates (79.6%). G (+) bacteria were 43.6% and G (−), 56.4%. Staphylococcus aureus was isolated in 8 cases (16.32%), Pseudomonas aeruginosa, 5 cases (10.2 %). 2. Sepsis developed in 14 cases (15.6%) and amputation was done in 15 cases(16.7%). The rate of infection by subtypes of type III open fractures was 3 cases (9.7%) in IIIa, 9 cases (21.4%) in IIIb, 2 cases (28.6%) in IIIc. Occurrence of amputation by subtypes of type III open fractures was 1 case (3%) in IIIa, 4 cases (10%) in IIIb, 10 cases (59%) in IIIc. 3. Occurrence of infections by the methods of treatment for soft tissue defect in type IIIB open fractres, was 17.6% in early treatment, 31.8% in delayed treatment. 4. In 35 cases treated with external fixation, delayed union developed in 15 cases (42.9%), nonunion in 4 cases (11.4%), infection in 7 cases (20%), osteomyelitis in 2 cases (5.7%). And in 38 cases treated with internal fixation, delayed union developed in 13 cases (34.2%), nonunion in 2 cases (5.26%), infection in 7 cases (18.4%), osteomyelitis in 1 case (2.6%).