We report a case of large bone defect after open tibial fracture treated with bone transport. The patient was a 38-year-old male who had left open tibial fracture (Gustilo Type III B) caused by a traffic accident. Débridement and fixation of the tibia with K-wires were performed, however, osteomyelitis developed. We then inserted GM-beads and applied an external fixator. The osteomyelitis of the tibia, however, did not subside. Nine months after injury, segmental resection of the tibia including infectious nonunion was performed and an external fixator for bone transport was applied. We started bone transport 8 days after the operation and continued for 160 days. After the docking of the transported segment to the distal tibia, we lengthened the tibia by 1cm. After 9 months, we carried out cancellous bone graft from the ilium to the docking site. About 1 year later, union was obtained and the external fixator was removed. The healing index was 61 days/cm. During the follow-up of 3 years and 7 months, the patient had neither fracture nor recurrence of osteomyelitis.
