A consecutive series of 245 fresh fractures of the tibial shaft, including 60 open fractures underwent operation in a 5 year period (1980-1984). Two hundred and forty-two (98.8 per cent) of these fractures were followed-up for an average of 79 months (6.5 years). Early and late complications as well as complications after implant removal were taken into account for closed and open fractures. In the 185 closed fractures, infection was observed in 1.7 per cent and delayed union in 6.8 per cent. More than 94 per cent of the closed fractures had an excellent or good late result. In open fractures (60 cases) infection was seen in 6.8 per cent, and plate fatigue with delayed union was seen in 10.3 per cent. However an excellent or good functional result was obtained in 93 per cent of the open fractures. After implant removal refractures occurred in 1.3 per cent and other minor complications in 0.9 per cent.