To investigate the treatment for tibial exposure wounds. 39 patients with tibial exposure wounds were divided into three groups according to the exposure location (upper, medium and below). The local muscular flaps were designed to cover the tibial exposure, followed by skin grafts and VSD. VSD was removed one week later. All the muscular flap and skin graft survived. Mild epidermis erosion happened in 2 cases, which healed spontaneously after dressing. The patients were followed up for 3-6 months with good healing and no walking malfunction. The local muscular flap combined with skin graft and VSD is a simple and effective method for tibial exposure wound with short healing time and high successful rate.