Corticotomy First Technique in Treatment of Distal Tibial Infected Nonunion

A 61-year-old diabetic female had infected nonunion of the distal tibia fixed with plate and screws with intra-articular penetration of the distal screw. The operative steps included corticotomy first technique of the upper healthy part of bone followed by removal of the hardware, debridement, and fixation of the very small distal tibial fragment with wires. Then, the frame was extended to the heel to improve the stability. A 5 cm lengthening was achieved and complete union of the docking site and fair range of ankle movement with no recurrence of the infection.