Four hundred and eighty-six patients with an tibial shaft open fracture scheduled for a open reduction and fixation procedure were randomized into receiving negative pressure wound therapy (NPWT) or standard dressing for wound management. The primary outcome of interest was the Disability Rating Index (DRI) at 12 months post-operation. The secondary outcomes of interest included the following: quality of life using via the 12-item Short-Form Health Survey questionnaire (SF-12), incidence of wound infection at 6 weeks, and the incidence of non-union at 12 months post-operation. Furthermore, DRI was measured at 3, 6, and 9 months post-operation. Finally, the quality of wound healing was also evaluated using a Visual Analogue Scale (VAS) at 12 months post-operation. The results demonstrated no significant differences in DRI scores between the 2 treatment groups. All secondary outcomes were not significantly different between the NPWT and standard groups. However, patients in the NPWT group reported significantly higher satisfaction with the quality of the wound healing compared to the standard dressing.