Road traffic accidents (RTA) is the most common cause of open fractures of long bones, increase in RTA leading to increase of complex non-unions incidence. the Participants are usually undergoing multiple surgeries for healing or to eradicate infection, which in turn leading to loss of bone and soft tissues and require skin grafting, muscle pedicle graft or bone grafting. Sometimes the Participants end up with deformity, limb length discrepancy, joints stiffness, disuse osteoporosis and muscle atrophy after management

Inclusion Criteria:

• Age from 18-60 years old.
• Open Grade II, Open Grade III (a & b) diaphyseal fractures of Tibia (judged after primary and/or secondary to debridement).
• Bone defect < 10 cm.
• Patients with Injury severity score (ISS) < 17.

Exclusion Criteria:

• Massive bone defect > 10 cm.
• Patients with ISS > 17, polytrauma patient.
• Age < 18 years old or > 60 years old.
• Associated vascular injury ischemic limb.