• Satoshi Hatashita, Ryoichi Kawakami, Soichi Ejiri, Nobuyuki Sasaki, Narihiro Toshiki, Masayuki Ito, Shin-Ichi Konno, and Michiyuki Hakozaki.
• Department of Traumatology and Reconstructive Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan. hatashi@fmu.ac.jp.
• Eur J Trauma Emerg Surg. 2021 Aug 1; 47 (4): 1153-1162.

IntroductionThe reconstruction of bone defects of open lower leg fractures is challenging, and there is no established treatment strategy to date, especially in the acute phase. We report herein an 'acute Masquelet technique' for reconstructing bone defects of open lower limb fractures as the primary treatment in the acute phase.Patients And MethodsWe retrospectively analyzed the outcomes of seven lower limbs of the seven Japanese patients (five males, two females, aged 24-76 years [mean 53 years]) who underwent the acute Masquelet technique for open fractures with bone defects. We evaluated postsurgical complications including deep infection, absorption of grafted bone, and the final result of the bone union.ResultsDeep infection occurred in one of the seven limbs (14%). There was no case with absorption of grafted bone in our series. We have treated two patients who needed additional surgery for delayed bone union. Bone union was eventually obtained in all seven limbs. All of the patients became pain-free and could walk without a cane.ConclusionThe 'acute Masquelet technique' was quite useful for reconstructing bone defects of open lower limb fractures as the primary treatment in the acute phase. We believe that this is one of the options that might be successful in the treatment of open lower limb fractures.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.

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