The Ilizarov technique for limb lengthening can solve the problem of shortening deformity due to limb replantation after high-energy injury. However, the specific time-points and speed of limb lengthening and the treatment of complications have been thorny issues. In the present case, a 26-yearold male who presented with 12-cm left limb shortening caused by the replantation of the left severed leg, and then treated with the Ilizarov technique to lengthen it simultaneously on the ends of osteotomy and replanted bone. After the limb length restored to normality, tibia bone transport was performed. Considering the unsatisfactory mineralization of the lengthened segment, the external ring fixator was replaced with a splint for temporary fixation, which accompanied with an angular deformity of the lengthened segment. And then a locking plate plus autologous ilium graft was performed to improve the stability and mineralization of the lengthened bone segment. Finally, left lower limb returned to equal length with right one while standing, and the left ankle joint remained in the functional position. In conclusion, this case showed satisfactory follow-up results in terms of limb function and X-ray images. Our study demonstrated that the Ilizarov technique is an effective treatment for shortening deformity after limb replantation.

Chronic osteomyelitis is a chronic infectious disease of bone tissue, which can cause necrosis of bone and surrounding soft tissue, and is a common complication of open fracture, internal fixation, diabetic foot and blood-borne bone infection. Traumatic osteomyelitis is caused by bone tissue infection after open fracture surgery or open reduction of fracture or other bone and joint surgery. The lesion is near the fracture end.Intramedullary infection is the most serious infection in acute stage, with high fever, chills and other toxemia symptoms, similar to acute hematogenous osteomyelitis. The other is the skin and muscle necrosis infection near the fracture, which makes Fractures that lose blood supply are exposed to air and become dry and necrotic, and the course of disease turns to chronic, often accompanied by infectious nonunion or bone damage. The course of disease is prolonged and the treatment is difficult. Subtrochanteric femoral fracture with postoperative chronic osteomyelitis is a rare condition requiring complex treatment. In the present study, we report on a 49-year-old male patient who received open reduction with intramedullary nail fixation due to subtrochanteric femoral fracture, but later suffered postoperative infection and developed chronic osteomyelitis. On the basis of the complete removal of the osteomyelitis lesion, we performed a 1-stage operation where free vascularized fibula was used to repair the bone defect, followed by effective internal fixation. The patient was followed up for 24 months and finally recovered from chronic osteomyelitis, with good functional recovery of the hip joint and a Harris score of 85.