The Elevator Fragment Technique of Ilizarov in the Tibial Bone Nonunion with Bone Loss

The management of nonunions with significant loss of bone remains a very difficult challenge for orthopedic surgeons. Several techniques have been developed, for some with difficult realization, and without convincing result for others. Our study involved two patients between 2012 and 2015, whom developed a tibial bone nonunion with significant loss of bone and having benefited from the elevator fragment technique using the Ilizarov external fixator. The evolution was good with filling of the bone loss and consolidation of the proximal osteotomy and the tibial nonunion with normal-oriented tibia. The filling of big post-traumatic bone losses by bone segmental transport, initially proposed by Ilizarov, finds its place in the reconstruction of the members, especially the tibia. This method is superior to other reconstruction techniques, in preserving the bone structure and equalizing its length. This technique has been adapted to be better tolerated by patients and more accessible to surgical teams, specifically the optimization of unilateral fixators for bone transport.