Fig. 1.

The treatment of FRI consists of consecutive management steps. The radical debridement of necrotic bone or devitalized sequestra is a key procedure for infection control accompanied by calculated antibiotic therapy. The implantation of a ceramic bone substitute with an antibiotic-eluting component is used for infection and dead space management. The osteoconductive feature of the ceramic bone substitute enhances the likelihood for bone healing and does not require surgical removal. Different methods for soft tissue and bone reconstruction are available with, e.g., bone segment transport (e.g., Ilizarov, hybrid fixation, PABST, Masquelet). During infection management, a rigid bone fixation is mandatory with temporal external fixation to ensure a supportive healing environment