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Objective:Observation on the effect of Ilizarov extal fixation combined with vacuum pressure sealing drainage and antibiotics in the treatment of infective tibial nonunion. Methods:79 patients with tibial infective nonunion who were treated in our hospital from August 2016 to August 2018 were divided into two groups according to random number table, with 39 patients in the control group treated with Ilizarov extal fixation technology and 40 patients in the study group treated with vacuum pressure sealing drainage and antibiotics on the basis of the control group. Bone healing time and daily walking were recorded. Rasmussen score, serum intercellular adhesion molecule-1 (ICAM-1) and IL-6 levels, lower limb Fugl-Meyer motor function score and lower limb BI index score were compared at different time. Results:The daily walking condition of the study group was significantly better than that of the control group (P < 0.05), and the healing time of bone was significantly shorter than that of the control group (P < 0.05); the Rasmussen score of the study group was higher than that of the control group at 1 month, 6 months and 12 months after treatment (P < 0.05); the levels of serum ICAM-1 and IL-6 in the two groups after treatment were lower than those before treatment (P < 0.05), and the levels of serum ICAM-1 and IL-6 in the study group were lower than those in the control group after treatment (P < 0.05). The lower limb Fugl-Meyer motor function score and lower limb BI index score of the two groups after treatment were higher than those before treatment (P < 0.05), and the lower limb Fugl-Meyer motor function score and lower limb BI index score of the study group after treatment were higher than those of the control group (P < 0.05).Conclusions:Ilizarov extal fixation combined with vacuum pressure sealing drainage and antibiotics can promote the bone healing of patients with infective tibial nonunion, significantly improving their daily walking condition, alleviating inflammation, and recovering the knee joint function and lower limb function well.