Motorized Intramedullary Transport and Lengthening Nail Used to Reconstruct a Nonunion/Bone Defect of the Tibia

A 53 year old male presented with a tibial nonunionTibial non-unionMotorized intramedullary transport with a varus deformity of 16° and 2.2 cm shortening of the tibia. The nonunion site (3.1 cm bone segment) was resected until vital bone was reached. The proximal tibia and the fibula were osteotomized. A custom-made tibial nail with the ability to do initial bone transport and subsequent bone lengthening was inserted. At 4 weeks after surgery, bone morphogenetic protein (BMP-7) was administered to the docking site. At the latest follow-up, 18 months after nail insertion and 3 months after nail removal, the patient did not have any pain or restrictions in daily activities. There was no leg length discrepancy and the tibia had a 3° varus deformity.