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. 2022 Sep 14;33(9):64. doi: 10.1007/s10856-022-06685-0

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© The Author(s) 2022

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 3 — The therapeutic process of the second typical case. A, B The initial X-ray displayed the patient suffered the tibial comminuted fracture; C–E the patient underwent the surgical treatment, and at 10 months after the initial surgery, X-ray and CT scan showed fracture nonunion and sequestrums; F we cleared the sequestrums and filled a PMMA spacer into the femoral defect with 6.3 cm length, and stabilized the femur by external fixator; G–L after an 8-week interval, the bone defect was repaired by a customized 3D printed scaffold, and the postoperative regular X-rays also showed the scaffold kept stable and new bone grew gradually on the surface of scaffold from both ends of the defect (as displayed in the red boxes)