34 patients with non-unionized tibial shaft fractures for at least 1 year undergoing oblique fibular osteotomy with compression using unilateral external fixation were randomized to receive either an active or dummy electrical stimulation treatment. This study aimed to determine the effect of electrical stimulation on radiological union rates. Results compiled over 5 years revealed a significantly higher union rate for those who underwent active electrical stimulation compared to the dummy treatment. Sub-group analysis of smokers versus non-smokers yielded no significant differences.