The aims of the treatment of tibial infected nonunions with bone and soft tissue loss (generally consequent to open fractures) are: the healing of infection, the bone consolidation with preservation of lower limb length and the reconstruction of soft tissue loss. The epider-mato-fascio-osteoplasty according to Umiarov (a modification of bifocal or multifocal compression-distraction osteosynthesis) enables to treat wide areas of bone and soft tissue loss without a preventive sterilization of the infection neither soft tissues closure and without bone and skin grafts. An important point of the treatment is the prevention of complications such as: persistence of infection (due to an insufficient debridement), trouble in formation of bone regenerate and /or callus at the docking site (due to inadequate configuration of the external fixator, imperfect management of the phases of treatment, obstacles on bone transport), defect of skin coverage (due to an improper rate of bone and soft tissue transport), complications at the site of application of the device (inflammation or infection, breaking of the fixation elements), functional impairment (knee and ankle stiffness).

In the 54 patients treated the anatomical and functional results have been particularly favourable, thanks to an accurate preoperative planning and a careful postoperative management, diminishing the risks of complications.