Fig. 3

Patient 1, who was injured in a motorcycle accident 12 years earlier, which had caused an open fracture of the right tibia and fibula, received ‘debridement and internal fixation of the open fracture of the right tibia and fibula’ in the local hospital. It was found that the bone healing ability was poor 2 months after the injury, and the patient was thus given iliac bone grafting again. It was found that the tibia was not healed and the plate was broken 5 months after the injury, thus the internal fixation was removed in the local hospital. Subsequently, there was right tibial nonunion, limb deformity, and knee pain. a Photo of the affected limb shows varus deformity of the right leg; b, c Preoperative X-ray shows typical synovial pseudoarticular nonunion with obvious broken end space, accompanied by a poor force line of the right tibia and degenerative changes of the knee joint; d, e Postoperative X-ray shows that the tibial force line is corrected, the internal fixation position is appropriate, and the bone graft is satisfactory; f, g X-ray examination 13 months after the operation shows satisfactory tibial healing and (h) the appearance of the lower leg has improved