26 yr old sustained acomminuted compound fracture which was treated with a monolateral fixator. To eradicate infection bone was resected to the extent that a 9 cm gap was created at the end of 15 months of treatment.
The ilizarov fixator was applied with thin wires at the lower tibia and a lower tibial low energy corticotomy was performed and the intermediate gragment is gradually transported proximally.
There is a foot frame necessary to give stability to prevent equinus deformity after distal lengthening. When specific rules are followed, walking is easy and pain-free.
Result after 11 months of treatment. The upper tibial gap is completely filled up and the NonUnion is completely healed. Infection is eradicated.