These days RTA and violence are on the rise and accounting for more cases of trauma in which bony injuries are common .Fracture of tibial shaft is due to its subcutaneous location is very often involved in these kind of injuries.this study was done to evaluate the effectiveness of external fixator as primary and definitive treatment for open tibia fractures, fractures with severe soft tissues injuries, threatened compartment syndrome, and in multiply injured patients 
Intramedullary nailing is considered the method of choice for treatment of closed diaphyseal fractures of long bones. However, there is controversy in the literature regarding the best way of managing open type II and type III fractures, tibial shaft fractures with severe soft tissue injuries or compartment syndrome, multiply injured patients.
Material and Methods: A total of 16 patients who satisfied our inclusion and exclusion criteria were taken and were treated with AO external fixator as primary or secondary to failed Intramedullary nailing . patients were assessed radiologically and clinically.
Results: as per clinical parameters of Karlstrom and Olerud 37% patients had excellent outcome 31% had good outcome 18% had fair outcome and 12% had poor outcome.
Conclusion: Meticulously primary wound debridement at earliest is an absolute. Which augments prognosis and prevents complication. External fixator is now accepted, reliable and convenient method to manage open Long Bones fracture.