Objective To compare the clinical effect of vascularized fibular flap transplantation and vancomycin sulfate calcium on chronic osteomyelitis of the tibia and bone defects.Methods A total of 35 cases with chronic tibial osteomyelitis and bone defect were involved and divided into group A with 21 cases receiving anastomosis of vascularized fibular flap transplantation and group B with 14 cases recciving vancomycin sulfate calcium.Infection control rate and Enneking score were compared in both groups.Simultaneous detection of two groups preoperative,postoperative 2 weeks,1 month and 3 months of the levels of CRP and PCT were conducted.Results Postoperative CRP and PCT were under control in both groups.No statistical significance was found in the comparison of CRP and PCT preoperative and postoperative 2 weeks,1 month and 3 months.In terms of infection control rate,two groups had no signiticant difference (P ＞ 0.05) and there was statistical significance of the comparison of postoperative Enneking score (P ＜ 0.05).Conclusions The clinical results of the two methods are satisfied.The infection degree and the length of the bone defect are decisive factors in choosing the treatment method and sometimes the combination of two treatment methods may be a better choice.