The success of interlocking nailing of femoral fractures promptly resulted in exploring the possibility of using similar techniques in the management of tibial fractures. The success has been so great that today it has become the treatment of choice for many such fractures. In closed tibial fractures associated with significant soft tissue damage and initial major shortening and displacement, intramedullary nailing is the preferred treatment for many orthopedists. We question, however, the extension of the method at this time to the treatment of many low-energy fractures of the tibia for the following reasons. The procedure is not free of complications. Infection is rare but it has been reported to range between 1 and 5%. If the infection migrates down or up the shaft, management of the complication becomes a difficult and often unrewarding task.