The lower leg is composed of two bones, shinbone (tibia) and calf bone (fibula). Tibial fractures are the most common fractures of all long bones in the human body with incidence of 2 per 1000 in a year, more frequently affecting younger men. They occur in both high energy trauma, such as car accidents, downhill skiing, and cycling accidents, and low energy trauma such as falls, contact sports, distance running etc. These fractures are clinically presented as pain in the affected limb, edema, deformity of the lower leg, also the patient cannot stand on their feet. The clinical picture may vary depending on the anatomic location of the fracture, so in conjunction with proximal tibial fractures, ligamentous and meniscal injuries frequently occur, and in the case of pilon fracture, injury of tibiofibular sindesmosis may be present. The diagnosis is confirmed by radiological findings, usually anteriorposterior and lateral x-ray should be obtained, while in case of tibial plateau fractures, the third, intercondylar projection has proved to be useful. In presence of more extensive injury , or injury involving soft tissue, the finding may be complemented by CT scan or MRI. Initial management of tibial fractures includes immobilization, analgesics, elevation of the limb above the heart level, and ice. Conservative treatment is based on three Boehler's principles: reposition, retention and rehabilitation. Fractures without displacement can be treated nonoperatively, with manual reposition and cast immobilization for 12 weeks. Fractures with displacement, major angulation, neurovascular injury or open fractures are treated operatively, by internal or external fixation. Lower leg fractures can be complicated by acute compartment syndrome, neurovascular injury or infections. Rehabilitation should be started as soon as possible after injury.