Fig. 2.

Following the excision of the sinus tract and radical surgical debridement of the impaired bone, a bone defect of 5 cm was formed. This was managed with a two-staged procedure (Masquelet technique). During the first stage, an antibiotic-loaded cement spacer was inserted, and the bone was stabilised with an external fixator. Two months later, the second stage involved incision of the induced membrane and removal of the cement spacer. The bone defect was subsequently filled with graft obtained from the ipsilateral femur using the RIA technique, mixed with BMP-7. Finally, the membrane was closed and the long bone was internally fixed. a) Radical debridement of the devitalised tissue and resulting bone defect; b) Induced membrane around the cement spacer, two months after the first stage procedure; c) Containment of the graft within the membrane.