Introduction: Ilizarov technique is one of the excellent methods used for bony lengthening. The current literature states that the maximum possible amount of tibial lengthening by bifocal transport of an Ilizarov apparatus was 22 cm, while the maximum amount of tibial lengthening by unifocal transport of an Ilizarov apparatus was 14.5 cm.
Case report: 40 years old Saudi teacher was presented with an open fracture at right tibia of type 3B. Second debridement was done and ended up with 21.49 cm bone loss of middle Tibial segment. Local flap plastic surgery was done to cover the skin defect and the bone transport was done with a rate of 1mm/day. The overall healing was excellent, and the patient returned to his preinjury functional activity and rejoined his job as a teacher.
Conclusion: Thus, the current case report is a unique new record of 21.49 cm of tibial lengthening achieved by Ilizarov apparatus using unifocal transport. This will be a treatment hope for the patients with excessive bone loss.
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