The authors have reviewed 47 cases of septic non-union of the tibia treated by tibio-fibular graft, Bone union was obtained in 31 cases, 2 limbs were amputated and 13 tibiae were united after another procedure. In 17 cases the grafts were performed in the presence of a discharging sinus. These cases did as well as any others. In cases of bone loss after diaphyseal resection, tibio-fibular grafting appeared to be a better procedure than Papineau's technique. Several cases of failure of this technique were cured successfully by tibio-fibular grafting when the bone loss was extensive, tibio-fibular grafting had to be completed by a supplementary tibial graft. The authors consider that grafting procedure should be done early in cases of extensive bone loss or in cases of severe compound comminuted fracture.