Numerous reports list predictive criteria to determine whether Gustilio-type tibial III-B and III-C fractures of the tibia are salvageable. What is lacking are long-term reports of comprehensive functional outcome of these severe injuries. We evaluated the functional outcome of patients with our own seven-scale score. Fifty-four patients with 57 types III-B (n = 41) and III-C (n = 16) open tibial fractures sustained between 1980 and 1989 were recalled for evaluation. There were 45 men and 9 women (average age, 28.4 years; range, 4-68 years). Follow-up periods averaged 48.2 months (range, 12-116 months). Salvage rate for the III-B fractures was 75% (n = 31) and for the III-C fractures 37% (n = 6). We conclude that the functional score is a simple and complete method for assessing the functional outcome of patients undergoing limb salvage procedures.