In addition to general charceteristics of tibial fracture, segmental tibial fracture is commonly combined with extensive soft tissue injury, comminution and displacement with poor blood supply in its middle segment. According to recent reports, intramedullary nailing was regarded as the excellent method in the management of this kind of fracture. Twenty-one cases were treated at the department of Orthopaedic Surgery, National Medical Center from January 1980 to December 1987 and following results were obtained; 1. Most common type of fracture was Type I (38.1%). Almost all the fractures were accompanied by open wounds(85.7%) and GIIIB open wounds were 12 cases(57.1%). 2. A verage union time was 31.8 weeks(union rate, 76.2%) and showed marked difference between closed fracture(20.2 weeks) and GIIIB open one(38.6 weeks). 3. Better results were seen in 8 cases of intramedullary nailing(average union time, 24.2 weeks), while all the plating method showed non-union in 3 cases of open wound.