Tibia fracture is often accompanied by soft tissue injury. There is controversy about the treatment of open tibia fractures, but the extemal fixator is most widely used as a initial treatment. Especially in open tibia fractures treated by extemal fixator, early secondary conversion to internal fixation device are suggested by some authors, but without risks of complication. In contrast others suggest that bone union problems are not due to external fixator itself and different types of bone union are observed according to the stability of fracture site.

The purpose of this study is to assess the clinical results with its affecting factors and to observe the morphological pattern of union in tibial open fractures treated by external fixator without significant soft tissue problems.

Authors analyzed 16 cases with tibial open fracture managed by external fixator in Ansan hospital, College of medicine, Korea University from May, 1988 to Sept., 1993 with follow-up period more than 11 months.

1. The tibial open fractures are mainly occurred in young active age group(20-50 yrs).

2. The union rate in accurate reduction and stable fixation cases was 90%, in contrast non-union rate in unstable fixation was 50%, and these non-union cases were managed by additional procedure(intramedullary nailing or autogenous bone graft).

3. In stable fuation, mode of fracture healing was mainly primary osteonal bone healing mechanism.

4. External fixator could be used in open tibial fracture with accurate reduction and stable fixation not as a temporary fixation but as a treatment modality.