Thirty-one patients with complicated ununited fractures of the tibia were treated by placing Phemister-type bone grafts of cortical and cancellous bone across the interosseous space in an attempt to produce a synostosis between the tibia and the fibula. In each case the site was drained postoperatively and drainage was continued for ten days with a massive pressure dressing. In nine cases, preliminary pedicle skin flaps were necessary to replace overlying scars or defects. In all cases but two, bony union was obtained sufficient to permit weight-bearing and to enable the patient to return to work.