This study aimed to assess the methods and curative effect of surgical treatment for post-traumatic osteomyelitis of the tibia. From March 2005 to June 2012, a total of 76 patients (49 male patients and 27 female patients) with posttraumatic osteomyelitis of the tibia were enrolled. Among the 76 patients, 9 patients were treated with infection elimination and bone graft surgery of vancomycin-loaded calcium sulphate; 60 patients with bone and soft tissues defect were treated with infection elimination, flap graft surgery and vancomycin-loaded calcium sulphate; 7 patients were treated with infection elimination and bone transport. 6 cases of transplanted flaps necrotized partly after the surgeries, but the wounds healed after dressing changing or skin grafting; 4 cases of sinus recurred, and the patients were cured by reoperations. All the patients were followed up with the average period of three years, with the recurrence rate of 5.2% and cure rate of 94.7%. Taken together, after the thorough debridement, applying microsurgery techniques of flaps combined with bone graft of vancomycin-loaded calcium sulphate, could obtain satisfactory surgical results.