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Gunshot and blast  injuries  still continue to be a major problem for public health and economy. Blast injuries can also disrupt many systems on the body with many different effect mechanisms ( 8, 9, 12 ). Gunshot and blast injuries  can be together  the serious extremity trauma , may result with amputation.  It is very difficult to give decision about extremity amputation or extremity salvage surgery.   ( 13,  14,  15,  16, 18 ).  Therefore, the different scheduling criteria for limb salvage surgery were described by many authors.  

Gunshots or blasts  have caused many penetrating  injuries in Syria.   Many injured person were transfered to Şahinbey Hospital of Gaziantep University of Turkey. This hospital is also close to the North Border of Syria ( 60 km away ). So we treated with the many tibial fractures with high energy    trauma  in our clinic.

In our study, we had definitely treated  21 patients with high energy tibial fracture( including open fractures  )that were complicated and  firstly treated in Syria.