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Objective: To sum up experiences and lessons about management of soft-tissue reconstruction in open tibial fracture over a 6-year period.Methods: Twenty-two flap reconstructions were performed to treat soft-tissue defect of 22 patients with open tibial fracture Type IIIB (Gustilo) from 1993 to 1998. The cases were analyzed and discussed retrospectively after follow up of 12-61 months.Results: The size of the flap ranged from 6.6 cm2 to 28.18 cm2 and the rate of flap failure was 13.6％. Besides, 3 partial necrosis and 2 postoperative infections occurred in this series.Conclusions: For soft tissuedefect of delayed open tibial fracture Type HIB, flap reconstruction is still an optimal option. The experiences we obtained are ① to design a triangular skin extension or a small Z-plasty over the pedicle to reduce the flap tension; ② to select a unilateral external fixation to provide convenience for anysecondary manipulation; and ③ to use serial debridementto diminish flap failure. de