Fractures of tibia are often trouble-some because of their easy compounding and associated soft tissue injury, especially neurovascular tissue. Initial proper treatments for fractures of tibia with severe compounding are very important for a better prognosis. In the orthopaedic Department of the Seoul Adventist Hospital, open reduction and internal fixation with Sherman plate were performed for 12 cases of tibia with severe compounding from January 1975 to October 1980 and the results were as follows; 1. The age of the patients ranged from 11 years to 50 years, and the majority of the patients were injuryed in traffic accident. 2. All of the patients were suffered from combined injures, so intensive close treatment was needed but 2 patients expired. 3. 7 out of 12 cases were found as vascular rupture and therefore 2 B-K amputations were carried out because of necrosis. 4. Average time for bone union was 6.9 months and infection was controlled without sequela. 5. Outcome of open reduction and internal fixation with Sherman plate for fractures of tibia with severe compounding was rather good, but comparisons are thought to be required after standardization of patients for open reduction without internal fixation. and openreduction with internal fixation.