Objective:Determining the effective of treatment for open tibial fractures with interlocking intramedullary nail,and comparing the clinical results of intramedullary nailing for open tibial fractures after reaming with those of nailing without reaming.Methods:Sixty-eight patients who had open tibial fractures were randomize into two treatment groups.Thirty-six fractures (five type~Ⅰ,eight type~Ⅱ,seventeen~ⅢA,six type~ⅢB) were treated with reaming nails,and thirty-two fractures (three type~Ⅰ,six type~Ⅱ,sixteen type-ⅢA,seven type~ⅡB) were treated without reaming nails.Main outcome measurements were average blood loss and operative time,compartant syndrome,union,infection,failure of the implant and anterior knee pain.