Management of a long segmental defect at the proximal meta-diaphyseal junction of the tibia using a cylindrical titanium mesh cage

This case report describes a Gustilo Anderson type IIIB tibia fracture associated with extensive segmental bone loss at the proximal meta-diaphyseal junction associated with a tibial plateau fracture and an avulsion of the tibial tubercle. After the tibial plateau fracture was stabilized using cannulated lag screws, the shaft fracture was stabilized using a statically locked intramedullary nail in combination with a cylindrical titanium mesh cage and cancellous bone graft. The soft tissue defect was covered with local flaps. Immediate full weight bearing was initiated, and early functional recovery was achieved. At the final follow-up, plain radiographs demonstrated excellent limb alignment, and bony healing with computed tomography examination revealed bony ingrowth through the cage. This technique may be a reasonable alternative in the treatment of segmental bone loss of long bones.