Clinical Scorecard: Utilization of a Combined Flap and Masquelet Technique with a 3D-Printed Titanium Cage for the Reconstruction of Traumatic Heel Defects: A Case Study and Review of Existing Literature

At a Glance

Key Highlights

• First application of combined flap technique and 3D-printed titanium cage for heel reconstruction
• Staged surgical approach with emergency debridement and flap reconstruction
• One-year follow-up showed satisfactory functional outcomes and minimal pain
• Integration of Masquelet technique enhances anti-infection benefits
• Custom 3D-printed prosthesis provides structural support and stability

Guideline-Based Recommendations

Diagnosis

• CT scan for assessment of fracture and soft tissue damage
• Clinical evaluation of functional impairment and soft tissue viability

Management

• Staged surgical approach including debridement, flap reconstruction, and prosthesis implantation
• Use of combined pedicled and free flaps for extensive soft tissue coverage

Monitoring & Follow-up

• Regular follow-up for infection signs and functional recovery
• Radiographic imaging to assess prosthesis positioning and bone healing

Risks

• High risk of infection and necrosis in severe soft tissue injuries
• Potential complications from flap surgeries and prosthesis integration

Patient & Prescribing Data

59-year-old male with extensive heel and ankle soft tissue defects

Successful integration of multiple surgical techniques for complex heel reconstruction

Clinical Best Practices

• Employ a multidisciplinary approach for complex traumatic injuries
• Utilize advanced imaging for precise surgical planning
• Consider patient-specific solutions like 3D-printed prostheses for optimal outcomes

Related Resources & Content

• American Orthopedic Foot & Ankle Society (AOFAS) score
• Maryland Foot Score