Tibial shaft fracture with ipsilateral tibia plateau fracture or segmental tibial shaft fracture with large fragment are frequently caused by high energy trauma and ideally treated by intramedullary nailing for the preservation of the soft tissue structure. However, the treatment can be very troublesome due to the extended fracture line into the nail insertion site of tibial plateau fracture or the difficulty of holding the fracture reduction of segmental tibia fracture for nail insertion. Here

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... we report 3 cases of tibial fractures more simply treated by intramedullary nailing combined with plate fixation of the proximal fragment.