Background: Tibial fractures are high-velocity injuries and are prone to be open fractures due to their subcutaneous nature. The study aims to compare functional outcomes following grade III B fractures of the tibia and to study the correlation between the functional outcomes of a limb following fractures of the tibia with a functional clinical score. Methods: This was a study involving all cases of open diaphyseal fractures of the tibia treated in the Department of Orthopaedics, Christian Medical College, Ludhiana, Punjab. The period of study was retrospective from 1 January 2000 to 31 December 2005 (6 years) and prospective from 1 January 2006 to 31 December 2006 (1 year). The total follow- up period was 1 year. Results: Varus deformity was associated with all types of AO fracture patterns. The greatest deformation was observed in the 29-38 years age group. Valgus deformity was most common in the 29-38 years age group, most of which wereassociated with his AO type C3 fracture (85%). Shortening occurred primarily in associated with C3-type AO fractures(80%). Overall, knee stiffness was lower in all age groups compared to ankle and subtalar stiffness. Gait patterns changed in all age groups. Return-to-activity rates were very low in the 18-28 and 39-48 age groups. Conclusions: External fixator remains the treatment of choice in the Indian scenario with better cost-effectiveness and early functional return. The younger age group had a better outcome than the older group. However, despite malunion and shortening, patients may have excellent/good outcomes.