Fig. 1A–D.

(A) This radiograph shows a 5-day postoperative, Grade I, open, segmental fracture of the left tibia treated with unreamed interlocked IMN and preventive fasciotomy. (B) Six months later, after removal of the IMN, an external fixator was applied and sequestrectomy was performed because of osteomyelitis. (C) Another 3 weeks later, after removal of the external fixator, reaming was performed of the intramedullary canal and a 13-mm diameter cannulated tibia nail was inserted without distal locking. (D) Ultimately, 56 weeks and nine operations after the initial trauma, union of both fracture lines occurred.