Bone Defect of Tibia Managed with a Bone Transport Nail

This case demonstrates the management of a diaphyseal tibia bone defect using the PRECICE bone transport intramedullary nail (NuVasive, San Diego, CA). The patient developed an infected nonunion of a traumatic open segmental tibia fracture prior to referral. After our initial debridement, he had a 65 mm bone defect. This defect was successfully managed with staged all-internal bone transport using the bone transport nail. The docking site required autologous bone grafting, and he was eventually converted to a trauma nail to further promote healing of the regenerate and docking site 9 months after transport nail insertion. He did require IV and oral antibiotics at the end of transport to treat lingering deep infection. At the conclusion of treatment, he is off antibiotics with a fully consolidated tibia, is full weight-bearing, and has full ipsilateral knee and ankle range of motion.