Osteomyelitis is a dangerous and unforeseeable event in the treatment of bone fractures.

In a 38-year-old patient, surgical treatment for leg fractures due to a domestic accident was complicated by osteomyelitis. To treat this severe complication, the following modality was followed: hardware removal, wide resection of the dead bone with debridement of the infected tissue, the implant of cement antibiotic-load spacer to fill the space, and a mono-axial external fixation. Subsequently, at the resolution of the infection, an Ilizarov external fixator was used, and a proximal tibia osteotomy was performed to obtain a distraction osteogenesis, while the gap at the distal tibia segment after the cement spacer removal was compressed. At the removal of the Ilizarov fixator, the clinical response was reasonable, but radiographically there was not a clear evidence of bone healing at the site of the previous fracture.