Various methods have been used in the treatment of tibial shaft fractures in adults. In recent years, generally accepted two surgical methods are compression plate with screw fixation and intramedullary nailing.

The authors reviewed 73 cases of tibial shaft fractures, treated by operation in Department of Orthopedic Surgery, Korea University Hospital from June 1986 to April 1993 and minimum follow up period was one year.

All cases were devided into 2 Groups, open reduction with compression plate fixation(35 cases) and closed reduction with interlocking intramedullary nailing(38 cases), and the two-groups were compared with each other.

The results were as follows:

1. The average time of clinical and radiological union were 17.5 weeks & 26.3 weeks in the compression plate group and 12.3 weeks & 18.5 weeks in the interlocking intramedullary nailing group respectively.

2. Bony union rate was not influenced by the level of the tibial fracture. It was delayed especially in the comminuted fracture.

3. Two cases of delayed union, one case of superficial infection and two cases of limited range of motion occured in the compression plate group.

Two cases of delayed union and one case of infection combined limited hee motion occured in the interlocking intramedullary nailing group.

4. According to our clinical study, interlocking intramedullary nailling is regarded as a better method for the management of comminuted tibial shaft fracture than compression plaate and screw fixation.