Sixty four cases of tibial shaft fracture in adult were treated by various methods at Department of Orthopedic Surgery, Koryo General Haspital during 3 years from March 1983 to Feb. 1986. The resuIts of 'treatment of these cases were analysed according to method of treatment, type and level of fracture, and degree of injury, in attempt to seek the most suitable method of treatment. The following results were observed 1. Of 64 cases of tibial shaft fracture, 24 cases were treated by cast immobilization, 16 cases by 0/ R and plate, screw fixation, 17 cases by Ender I-M nailing, 7 cases by Hoffmans ext. fixator. 2. The most common site of fracture was middle 1/3 of the shaft (62.5%). 3. On the union time of fracture, I-M nailing by use of Ender nail was more rapid than other methods of treatment. (average: 16.2 Wks. POD) 4. On the time of weight bearing, earlier weight bearing was possible by Ender I-M nailing than other method of treatment. 5. On the complications of fracture, fewer complications were developed after Ender I-M nailing than other method of treatment. 6. According to Modified Ellis classification, more rapid union was obtained by C/R and cast imm-obilization in the case of Minor degree, no significant difference among each group in the case of Moderate degree.