Treatment of open Tibial shaft fracture of I, II degree with intramedullary nailing was interested a lot of authors. Surgery to insert an intramedullary rod has showed more advantages compared to the combined by screws and bands in cases that has broken position in 1/3 below part of the tibia. From 2008 to now, Hai Phong Viet-Tiep Hospital has treated 83 cases of open Tibial shaft fracture of I, II degree with intramedullary nailing, and the results are quite good such as contributing to the return of motor function early, and shorten treatment time, and significantly reduce the rate of complications in patients.