Clinical Report: Combined Flap and Masquelet Technique for Heel Defects

Overview

This report details a novel approach to reconstructing traumatic heel defects using a combined flap technique and a 3D-printed titanium cage. The case study demonstrates successful outcomes in terms of infection control, structural support, and functional recovery.

Background

Open calcaneal fractures with significant bone and soft tissue loss are rare but pose substantial reconstructive challenges. Standardized treatment protocols are lacking, necessitating innovative surgical strategies to achieve effective limb salvage. The integration of advanced techniques such as the Masquelet technique and 3D-printed prostheses may enhance outcomes in such complex cases.

Data Highlights

Key Findings

• The case involved extensive soft tissue defects and a large segmental defect of the calcaneus.
• A staged surgical approach was utilized, including emergency debridement and coverage with antibiotic-loaded cement.
• A combined pedicled and free flap technique was employed for soft tissue reconstruction.
• A custom 3D-printed titanium cage prosthesis was successfully implanted after soft tissue healing.
• One-year follow-up showed satisfactory radiographic positioning of the prosthesis and acceptable functional outcomes.

Clinical Implications

This case underscores the importance of a multidisciplinary approach in managing complex heel defects. The combination of the Masquelet technique and 3D-printed prostheses may offer a viable option for enhancing both aesthetic and functional recovery in similar cases.

Conclusion

The integration of advanced surgical techniques provides a promising strategy for reconstructing complex heel defects, highlighting the potential for improved patient outcomes in challenging clinical scenarios.

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