From 1970 to 1973, twenty-eight severe open tibial fractures in twenty-seven patients were treated with stable external transfixation by the Vidal-Adrey double-frame method. Excluding one patient who had an amputation because of vascular damage at the time of injury, wound healing was satisfactory in all patients with no primary soft-tissue or deep infection. There was one late infection following secondary intramedullary nailing three months after injury. Secondary skin and bone grafts were part of the original plan of treatment and were easily performed. All patients were able to start range-of-motion exercises in the early postoperative period. In the case of a severely comminuted tibial fracture combined with arterial injury, this method made it possible to observe the limb for a few days before amputation for vascular insufficiency. The average time in the frame was 4.9 months, and then a patellar-tendon bearing plaster case or splint was used. The mean time until full weight-bearing without external support was 7.9 months. In the twenty-two patients who could be assessed, the final result was excellent or good in seventeen and acceptable in five.