A comminuted tibial fracture can be considered for conservative treatment if it is well aligned and aligned. For conservative treatment, external fixation in plaster or polymer splinting can be used. If the alignment is not good and there is no way to maintain the stability of the fracture even after external fixation with conservative treatment, surgical treatment can be considered. Surgical treatment is relatively more options, the most commonly used is internal fixation of the tibial intramedullary pin, which is the gold standard for tibial fractures and can minimize the bone exposure due to internal fixation. However, there is a risk of skin necrosis and plate exposure, and this surgical treatment option is not recommended if the soft tissue is not in good condition. In addition, open fractures should not be fixed with plates, and most of them should be fixed with intramedullary pins.