Poor alignment after a tibial fracture can be treated conservatively if it has little effect on healing and there is no damage to the articular surface. If the displacement is significant, it is difficult to restore normal function with conservative treatment, and there is damage to the articular surface, then surgical treatment is required. A tibial fracture is a fracture of a long bone, and poor alignment indicates that the injury is not too severe, so manipulation can be attempted first. The criteria for manipulative reduction are rotational displacement, separation displacement must be completely corrected, angular displacement must be completely corrected, and alignment of the fracture must be at least one-third of the fracture (at least four-thirds of the metaphyseal fracture). Surgery may be required if the above requirements cannot be met by manipulation, or if there is significant vascular or neurologic injury, or injury to the articular surfaces. The main form of surgical treatment is internal fixation with a cut-and-replace plate. The doctor will need to take appropriate measures according to the situation.