There is considerable difference of opinion about how patients with open
tibial fractures and considerable loss of skin should be treated. The
incidence of long-term complications from such lesions--that is, chronic
ulceration and chronic osteomyelitis--apparently is not recorded, but many
cases undoubtedly exist and are under treatment by methods that are short
of curative. Successful results in forty-three patients were obtained by
muscle transposition and delayed skin-grafting. Early coverage of open
fractures of the tibia with soft tissue will prevent the later development
of osteomyelitis, ulceration, and, perhaps to some extent, non-union.