Nine patients with nonunion of the tibia associated with angular deformity were treated using the Ilizarov device. Eight of these went on to heal the nonunion and had acceptable correction of the angular deformity. One patient with an atrophic nonunion and severe bone loss received a below knee amputation. The authors recommend the use of circular ring fixation as an alternative in the treatment of selected cases of stiff nonunion of the tibia combined with angular deformity, particularly if there is active infection, prior use of an external fixator, or poor soft tissue coverage.
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Ebraheim et al. (1995) studied this question.
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