Three Year Old Female with Segmental Bone Defect due to Grade IIIB Open Tibial Fracture Treated by Oblique Wire Bone Transport

Three year old female sustained multiple fractures in a rollover motor vehicle collision including bilateral closed femoral shaft fracture, stabilized internally with Rush rods and grade IIIB open left tibial/fibular shaft fractures with segmental bone loss and substantial soft tissue defect fixed externally with the Agee WristJack monolateral fixator following to irrigation and debridement (I and D). Four days postoperative, soft tissue necrosis necessitated second I and D with rotational soleus flap and split-thickness skin graft. Following soft tissue coverage, bone stabilization was converted to TrueLok circular external fixator to allow for proximal tibial osteotomy and 4-cm oblique-wire segmental bone transport.