Open fractures of the tibia remain a formidable injury. Which the need for stabillization of open tibial fractures is accepted, the method of fracture stabilization is still controversial because of unacceptable infection rate. External fixation has been the routine and safe procedure for open tibial fractrues. However, this is not without significant complications such as pin tract infection and delayed or nonunion due to insufccient stability.

We reviewed the records of 29 patients who underwent immediate unlearned locked intramedullary nailing for open tibial fractures. The average time between injury and operation was 2.4days. The classification of the open fractures was; fifteen Grade I, nine Grade II , and five Grade II a. There was no superficial infections, but one of type III a patient developed deep infection. Skin graft or rotational flap to cover the soft tissue defect were performed. All cases were treated by primary intramedullary nailing without a change of the fixator. So, we think unlearned locked intramedullary nailing is a good alternative method for the management of Grade I, II, III a open tibial fractures.