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TRUMATCHTM Graft Cage-Long Bone as a solution for tibial bone defect in traumatic aseptic non-union: a case report
Maud A M Vesseur1, Isobel M Dorling1, Bert Boonen1
1Department of Orthopaedic Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.
Background:
Tibial fractures, with an annual incidence of 51.7 per 100.000 adults, often result in complications like non-union and infection, particularly in open fractures. Non-union rates after intramedullary nailing are 9.7%. Hypertrophic non-union stems from unstable fracture sites, while atrophic non-union arises from inadequate biological environments. Treatment involves rigid bone fixation for hypertrophic non-union and combining biological tissue supply with mechanical stability for atrophic non-unions. This case report outlines a complex tibial non-union post-high-impact injury, detailing the surgical technique and TRUMATCHTM Graft Cage-Long Bone usage. In addition, we outlined the current literature on this topic.
Case Report:
A male patient suffered a traumatic Gustilo II comminuted tibia and fibula fracture, Lisfranc injury and a Schatzker I tibial plateau fracture of the right leg. During follow-up the patient developed an aseptic non-union with eight-centimeter anterolateral bone defect after primary surgery. Surgical intervention was performed using the three-dimensional printed TRUMATCHTM Graft Cage-Long Bone. At one year follow-up, clinical and radiological consolidation of the right tibia was seen.
Conclusion:
This case report describes a challenging case of aseptic traumatic non-union of the tibia with a critical-sized defect treated with a novel patient-specific implant in a one-stage procedure. The application of the TRUMATCHTM Graft Cage-Long Bone is promising and warrants further investigation in larger, more controlled studies to substantiate our findings.

