Background: The treatment of tibia fractures with a critical sized wound is complicated. When primary closure is not possible, the classic options are rotational or free flap coverage. Soft-tissue
coverage is critical to avoid infection. There are instances when flap coverage is not an option.We present an alternative technique for simultaneous bone healing and soft tissue closure using the Ilizarov method.Case Report: A grade IIIB open tibia fracture was treated with an Ilizarov external fixator. Wound debridement, removal of loose bone fragments and gradual compression across the fracture site led to bony shortening and union. Soft tissue transport led to secondary wound closure. An excellent anatomic and functional outcome resulted.Conclusions: This technique of bone and soft-tissue transport may prove useful in the treatment of tibia fractures with difficult to close wounds or for patients who are not candidates for flap coverage.

Keywords: Ilizarov, wound, Tibia