Fractures of the tibia are one of the most common injury encountered by orthopaedic surgeons and their treatments are considered to be difficult due to serious complications. Many treatment modalities were introduced. Among them, Ender nailing is considered one of the useful modality because it is a relatively simple and, 3ess invasive procedure

Authors analized 123 tibial fractures treated with Endr nails from Feb. 1986 to Feb. 1992 to solve the problems during Ender nailing. The follow up ranged from 12months to 51 months with an average of 11 months.

The results are as follows;

1. Among 123 patients,93 cases are male and 30 cases are female. Traffic accident is the most common cause of injury.

2. Average interval from injury to operation is 9 days and average 2.1 Ender nails are used. The mean duration of the bone union is 19.1 weeks.

3. To prevent knee joint pain, more distal medial and lateral portal of entry and more posteriorly located lateral portal of entry were used.

4. To provide stability of distal 1/3 fracture,3 or more nails are introduced with fanning in AP and lateral plane.

5. to provide stability of the comminuted fractures, convexities of at least 2 nails are located at the comminuted site.

6. To prevent rotation of the middle fragments of segmental fractures, technique of temporary Steinmann pin fixation for handling the middle fragment during operation were used.