Abstract
Abstract Infection and bone loss after local debridement in high grade open fractures are two difficult issues. The treatment of bone infection needs a wide “oncological” debridement that leaves a segmental bone defect. Once the infection is deleted, the defect may be treated with different surgical techniques: bone graft, bone transport, Masquelet’s two stage reconstructions, allograft or vascularised fibular transplant. In literature these options are described only for bone loss less than 15 cm. We describe a case of a lady with an open IIIA fracture of the right distal femur with 25 cm of infected bone loss, treated with wide multistaged debridement, Masquelet technique and ORIF with massive allograft and autologous bone graft. This case gives the possibility to discuss the following principles: wide debridement, biological chamber, two stage reconstruction, internal stable fixation in infected bone.
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