Objective To quantitatively judge the degree of tibial bone healing with the finite element wall thickness analysis, and to provide an intuitive diagnostic basis for clinical judgment of tibial "union" and "bone delayed healing". Methods 48 patients with clinical diagnosis of "union of bone" and "delayed healing of bone" were selected in our hospital from April 2013 to October 2018. All patients were followed up for 2 to 4 years. CT examinations were performed at different stages of bone healing, DICOM data was exported, and the maximum wall thickness score of the mesh model of the affected limb and the healthy limb was calculated by MIMICS software. The contrast value was used as a quantitative indicator of the degree of bone healing. The clinical diagnosis was conducted a second correction and the final clinical healing results were observed. Results Clinical diagnosis analysis and finite element wall thickness analysis were carried out in 48 patients during each review period, and 21 cases of delayed bone healing and 27 cases of bone nonunion were judged clinically.Among them, 2 cases were judged to be ineffective, and bone grafting intervention was adopted to replace the internal fixation, 12 cases were judged to be still effective, and all cases were finally healed by the surgical intervention of bone grafting alone.By Bowker test, P=0.094 (P>0.05) was obtained, and the wall thickness analysis method was consistent with the clinical diagnosis. Conclusion Bone healing is the recovery process of bone structure and biomechanical properties. It is the need of clinical work to dynamically and quantitatively judge the degree of bone healing. The degree of bone healing can be quantitatively analyzed and be quickly achieved with the technique of finite element analysis. The results of this group of cases confirm that the finite element wall thickness is superior to the simple clinical diagnosis method and has a better differential diagnosis value for early judgment of poor bone healing.