الفهرس 
The anatomic location for insertion of wiresOnly 14 pages are availabe for public view
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Abstract
Surgical reconstruction of tibial non-unions with or without
associated infection can be a great challenge for the
orthopaedic surgeon. These non unions are usually the result of
high-energy trauma accompanied by extensive soft tissue
damage at the time of initial injury. Bone defects can result
from these injuries primarily or secondarily from the
subsequent debridement for contamination or infection, or it
may result after the debridement of devascularised or
contaminated bone; prone to ischemic or septic necrosis. Bone
resection may also be indicated in the treatment of atrophic or
infected pseudoarthrosis and in the presence of bone tumors(1).
External fixation, which is a well-accepted treatment for
open fractures and damage control orthopaedics has acquired
increasing importance in the treatment of bone loss in recent
years. The technique proposed by Ilizarov involves the use of a
circular external fixation frame with bone-gripping elements
which transfix the limb(2).
The debate of treating those cases is mainly between two
methods, using Ilizarov as a method of fixation: acute
shortening and lengthening versus bone transport mainly for
looking into indications, complications, duration of treatment,
another surgical intervention and requirement of bone grafting
at the resected non union site.Acute shortening and lengthening technique implies
repair of the bony defect by initial compression and thus
shortening of the segment involved this is coupled or followedby
an osteotomy in a region furthest from the defect, at which
subsequent lengthening is carried out(3-4-5)
Bone transport technique implies an osteotomyis
performed proximal to the bone defect (ante grade transport), or
distal to it (retrograde transport). Subsequently, gradual
movement of the detached fragment towards the bone gap is
achieved via a process which is completed when the transported
segment reaches the end of the bone gap(6-7).
The main indication for the two techniques is different:
bone transport is indicated for the treatment of major bone loss,
whereas compression-distraction is suitable only for treating
less extensive bone gaps, since compression may compromise
neural and vascular structures.