PURPOSE : We evaluated the efficacy of intramedullary nailing in distal tibial fractures. Material and Method : Twenty-six patients with distal tibial fracture were treated with intramedullary nailing between Jan. 1996 and May 1998. Operation was done on the fracture table under skeletal traction. We evaluated the causes of trauma, type of fracture, location of fracture, time to union, malunion, nonunion, range of motion of knee and ankle, and degree of pain. RESULTS : There were 4 cases of open fracture and 4 cases of closed soft tissue injury at fracture site. The time to fracture union was 19 weeks on average. One case(3.8%) did not heal by 10 months and was classified as nonunion. The union rate was 96.2 % and the complication rate was 7.7%(one case of nonunion and one case of malunion). There was no infection and soft tissue disruption. The range of motion of knee was reduced in 1 case(3.8%) and 2 patients(7.7%) complained of mild pain at the knee joint. The range of motion of the ankle joint was reduced in 4 cases(15.5%), averaging 15.5 degrees in dorsiflexion and 9 cases(34.6%), averaging 21 degress in plantarflexion. Two patients complained of mild pain at the ankle joint. CONCLUSION : We had relatively good clinical and radiological results and concluded that closed intramedullary nailing is a safe and effective method of managing distal tibial fracture.