During a five-year period, 135 tibial fractures were treated with compression plating. In thirteen patients a delay in healing occurred owing to a lack of stability. Secondary intramedullary nailing after reaming of the medullary cavity was then done. In two other patients preliminary plating was performed and secondary intramedullary nailing at a later date was planned from the beginning. Only one of the thirteen patients had an infection which considerably delayed the healing, but the final result in this case was completely acceptable. In the other patients the intramedullary nailing was followed by uncomplicated healing. The final result was excellent or good in thirteen cases (87 per cent) and acceptable in two cases.