Large segmental necrosis of the tibia with deep infection after open fracture

Fifteen patients with large segmental necrosis of the tibia with deep infection, following open fractures, were treated according to the Burri-Papineau protocol. After radical debridement, the segmental bone defects averaged 8.4 (5-15) cm. Necrectomy, external fixation, and open cancellous grafting, in a two-stage procedure, gave infection control in 14 cases and bone healing in 12. Additional procedures, i.e., plating and posterolateral bone grafting, provided union in another 2 cases. One patient underwent amputation. Functional results in the other 14, after a follow-up averaging 4 years, were good in 9 cases, fair in 3, and poor in 2.