Ninety-two tibial shaft fractures in 90 patients over the age of 15 were treated by compression osteosynthesis according to the AO method, but using plates and screws of Vitallium. Fifteen fractures (14 patients) were excluded, because the follow-up period was less than 12 months. The frequency of complications in the remaining 77 fractures, 44 per cent comminuted and 30 per cent open fractures, were: skin necrosis over the osteosynthesis material: 5.2 per cent, osteitis: 1.3 per cent, delayed osseous healing necessitating secondary operation: 2.6 per cent, loosened screw (not requiring secondary operation): 5.2 per cent, loosened screw + refracture: 1.3 per cent, plate bending: 1.3 per cent, plate fractured: 1.3 per cent, and refracture after removal of the plate (new relevant traumas): 4.8 per cent. In this series there was a markedly high frequency of complications in comminuted fractures with laceration of skin and muscles, whereas an increased tendency for complications to develop in the remaining injury groups was not seen.