Fig. 4

a Radiograph of case no. 27 who was involved in a traffic accident resulting in right tibia open fracture and Gustilo IIIB. b Three weeks later, the patient was transferred to our center and there was lager soft tissue defects associated with facture. c-d The patient underwent the first debridement in our hospital 23 days after injury, and the previous external fixator was replaced with Ilizarov fixation. The wound was open after the necrotic soft tissue and bone was completely debrided, and treated with soft tissue distraction