Short-Interval Two-Stage Treatment of a Comminuted Open Tibial Diaphyseal Fracture

Open comminuted tibial fractures caused by gunshot injuries remain challenging due to the high risk of infection, bone loss, and prolonged functional impairment. We report the case of a young male patient who sustained a severe open comminuted tibial diaphyseal fracture with a large segmental bone defect following a gunshot injury. The patient was managed using a short-interval two-stage approach, consisting of early distraction osteogenesis with an external fixator followed by timely conversion to intramedullary fixation combined with autologous bone grafting. This strategy allowed effective reconstruction of the bone defect, achievement of solid union, and early restoration of limb function without major complications. This case highlights the potential benefits of minimizing the interval between treatment stages in the management of complex open tibial fractures.