Tibial shaft fracture with bone defect have had many obstacles in treatment. Since Ilizaiov reported the treatment of pseudoarthrosis and fibrous nonunion with distraction and transformstional osteogenesls by Ilizarov external fixator in 1954, it has been used in limb lengthening, intercalary deficiency, angulation and rotational deformity, active infection, ischemlc joint contracture, and nonunion. We treated tibial shaft open fracture (Gustilo type lIIB) with bone defect(6.5cm) by Ilizarov external fixator at Yong Dong Severance Hospital.