This case describes a 28-year-old man who presented with an infected tibial-fibular non-union, two years after sustaining an open tibia–fibula fracture in a road traffic accident. Despite initial treatment by a traditional healer and surgical management at Masanga Hospital, the fracture failed to unite. One year later after initial treatment, the patient presented with a persistent non-union with a chronic fistula. Definitive management consisted of thorough debridement, bone shortening and stabilisation with an external fixator.

1-Picture taken at patients house during follow-up.

Add
Video 1-Manipulation of the proximal and distal bone ends.
Video 2-Patient walking without crutches and climbing stairs. 
Video 3-Patiënt walking independently with a stable gait, at 1 year

This case concerns a 31-year-old woman who sustained a Gustilo–Anderson grade II open, multifragmentary fracture of the mid-shaft of her left femur following a road-traffic accident. Management took place at Masanga Hospital in Sierra Leone, a low-resource setting, where she underwent open reduction and definitive external fixation using a dual-frame construction.

This case involves a 21-year-old man who sustained a Gustilo–Anderson grade 3B open tibial shaft fracture of the right leg following a road-traffic accident. He presented with substantial soft tissue damage and segmental dead bone, which resulted in a large bone defect after debridement. He was treated at Kiruddu Hospital in Kampala using external fixation and a pedicled fibula flap.

This case involves a 50-year-old man who sustained a Gustilo grade 2 open femur shaft fracture of the left leg after a motorbike accident. He was treated in Masanga Hospital in Sierra Leone.

This case involves a 62-year-old man who sustained an open fracture of the left tibia after a motorbike accident. He was treated in Haydom Lutheran Hospital in Tanzania.