Management of Chronic Osteomyelitis Bone Defect with Titanium Cage Combined with the Masquelet Technique: A Case Report.

Introduction: Managing large segmental bone defects secondary to chronic osteomyelitis is a major challenge in orthopedic surgery requiring both long term and complex management. This study reports the outcome of effectively managing intra-articular tibial 12 cm bone loss with secondary to chronic osteomyelitis (COM) withsequential Masquelet technique followed by cylindrical titanium cage placement. Case Report: A 37-year-old male with chronic distal tibia osteomyelitis, unresponsive to prior treatments, underwent a two-stage Masquelet technique with titanium cage, autograft, and allograft for a 12 cm defect. Despite subsequent complications including plate breakage, varus deformity requiring revision, and plate removal due to skin complications, he achieved full pain-free weight-bearing within 1-year post-cage placement. Discussion: This report describes the first documented case of managing chronic osteomyelitis with this specific combined technique. It demonstrates successful long-term functional recovery in complex distal tibia osteomyelitis, with sustained efficacy over a 2-year follow-up, validating this reconstructive approach despite significant post-operative complications.