TRUMATCHTM Graft Cage-Long Bone as a solution for tibial bone defect in traumatic aseptic non-union: a case report.

Abstract

Background: Tibial fractures, with an annual incidence of 51.7 per 100.000 adults, often result in complications like non-union and infection, particularly in open fractures. Non-union rates after intramedullary nailing are 9.7%. Hypertrophic non-union stems from unstable fracture sites, while atrophic non-union arises from inadequate biological environments. Treatment involves rigid bone fixation for hypertrophic non-union and combining biological tissue supply with mechanical stability for atrophic non-unions. This case report outlines a complex tibial non-union post-high-impact injury, detailing the surgical technique and TRUMATCH^TM Graft Cage-Long Bone usage. In addition, we outlined the current literature on this topic.

Case report: A male patient suffered a traumatic Gustilo II comminuted tibia and fibula fracture, Lisfranc injury and a Schatzker I tibial plateau fracture of the right leg. During follow-up the patient developed an aseptic non-union with eight-centimeter anterolateral bone defect after primary surgery. Surgical intervention was performed using the three-dimensional printed TRUMATCH^TM Graft Cage-Long Bone. At one year follow-up, clinical and radiological consolidation of the right tibia was seen.

Conclusion: This case report describes a challenging case of aseptic traumatic non-union of the tibia with a critical-sized defect treated with a novel patient-specific implant in a one-stage procedure. The application of the TRUMATCH^TM Graft Cage-Long Bone is promising and warrants further investigation in larger, more controlled studies to substantiate our findings.