Aim: The role of external þxation in the deþnite management of open tibial fractures is reviewd based on a study of 180 tibial fractures during 1992– 2001. Method: From the 180 patients, 70 fulþlled the criteria (anatomical or acceptable reduction, optimal fragmemts contact, high rik for infection, technical difþculties for internal þxation) and was included to the study. Fractures were stabilized with a unilateral frame, or with V or delta frame. In sixty-one cases, bony consolidation in optimal aligment occurred. In the remaining nine patients, external þxation was removed because of major pin tract infection, loss of reduction or in delayed union. Results: Sixty-one patients achieved union with the external þxation in a mean time of 4,5 months (3 to 6 months). There was no malunion. Minor pin track infection was seen in 32/280 pin sites (11.4%). No remarkable shortening of the injured leg observed. After consolidation, 44 (72.1%) fractures had a very good or good functional recovery. An acceptable result was achieved in 16 patients (26.3%), and one (1.6%) had bad function of the injured leg. Conclusion : Given the stringent adherence to the important principles of þxator application, attentive choice of the patient and the type of the fracture, and well supervised follow up, we believe that deþnitive, successful management of open tibial fractures can be obtained with external þxation.