Single Stage Reconstruction of Atrophic Tibial Non-Union with Critical-Sized Bone Defect, Limb Length Discrepancy, And Equinus Deformity Using A Single Ilizarov Construct: A Case Report

Atrophic tibial non-union with critical-sized bone defect, limb length discrepancy (LLD), and equinus deformity presents a complex reconstructive challenge. We report a 28-year-old female with a 6 cm tibial defect, 7 cm LLD, and severe equinus (talotibial angle 77°) following trauma. Reconstruction was performed using a single Ilizarov system, combining trifocal bone transport, limb lengthening, and gradual deformity correction within one construct. Early outcomes demonstrate progressive regenerate formation, impro ved alignment, and correction of deformity. Preliminary ASAMI assessment suggests good functional progress, pending final evaluation after frame removal. This case highlights the effectiveness of a single-stage Ilizarov strategy for simultaneous management of the combined pathology, potentially reducing the need for staged procedures.