Abstract: [Objective] To evaluate the effectiveness of axial load-sharing ratio test in assessing the rigidity of callus for tibial fractures in removing unilateral external fixators. [Methods] Clinical data of 49 patients with tibial fracture admitted to Tianjin Hospital from January 2017 to July 2020 were retrospectively analyzed. All patients received unilateral external fixation of tibial fracture within 2 weeks after injury. According to random number table method, axial load sharing ratio was tested in 24 patients (test group) and not in 25 patients (routine group). The perioperative, follow-up and imaging data of the two groups were compared. [Results] All patients successfully completed the operation. There were no significant differences in operation time, intraoperative blood loss, intraoperative fluoroscopy times, walking time ,hospital stay, total incision length, incision healing and external fixator adjustment time between the two groups (P>0.05). The mean follow-up time was (10.5±2.4) months. As the postoperative time went on, the VAS score at the fracture was significantly decreased in both groups (P<0.05), and the knee flexion and extension ROM and ankle-plantar flexion and dorso-extension ROM were significantly increased in both groups (P<0.05). The frame time in the test group was significantly lower than that in the conventional group (P<0.05). There was 2 needle infection in the test group, and 4 cases in the conventional group. There was no statistically significant difference in the infection rate between the two groups（P＜0.05）.There was no recurrence of fracture in the test group and 1 recurrence of fracture in the conventional group. There was no significant difference in recurrence rate between the two groups (P>0.05). In terms of imaging, there was statistically significant difference between the two groups after the adjustment of fracture alignment compared with the immediate postoperative changes (P<0.05), but there was no statistically significant difference in fracture reduction between the two groups over time after the adjustment (P>0.05). After operation, the quality of callus formation in both groups gradually improved (P<0.05), and the quality of callus formation in the conventional group was significantly better than that in the test group (P<0.05). [Conclusion] Regular application of axial load sharing ratio test can safely and timely guide the removal of unilateral external fixator for tibial fracture, and the effect is safe and reliable.