Segmental fracture are characterized by two-fractures on different levels of the shaft with an intermediate segment. The treatment of segmental fractures of the tibia has many problems and the result are unsatisfactory due to poor blood supply of the intermediate fragment and serious damage to surrounding soft tissue, that usually occurs from high energy trauma. Thirty three cases with segmental fracture of the tibia were reviewed, which were treated at the Department of Orthopedic surgery, Soonchunhyang University Hospital for 4 years from January, 1986 to December, 1989. 1. Thirty cases (91%) were caused by traffic accident and eighteen (55%) were open fracture. 2. Closed and minor degree open fracture were treated mainly by intramedullary nailing and the result was relatively good except 4 cases of delayed union. Severe open fracture was treated, first, by external fixation. 3. The healing was fastest in Type I lesions and slowest in Type V. 4. High incidence of complications including infection, delayed union, and nonunion was shown in the severe open fractures those were treated by external fixation.