Full circumferential segmental bone loss of the tibia presents a challenge to orthopaedic surgeons. These open fractures often involve extensive soft-tissue damage, which can contribute to poor long-term outcomes even if the tibia is successfully reconstructed. Although amputation was historically used to treat full circumferential segmental bone loss of the tibia because of the severity of the injury, the development of new reconstruction procedures has provided the option of limb salvage techniques. I reviewed studies on treatment of traumatic tibia bone loss, focusing particularly on full circumferential bone loss of greater than 3 cm. Treatment options included amputation, allograft replacement, autologous bone grafting, use of vascularized fibular autograft, bone transport, and the Masquelet (induced membrane) technique. The most commonly used methods of limb salvage for treating full circumferential segmental bone loss are bone transport, use of vascularized fibular autograft, and the induced membrane method. Successful treatment, however, can depend on individual comfort levels of patients and physicians when deciding between the different approaches.
Strohmeyer, Gregory C.. "Treatment of Full Circumferential Segmental Bone Loss of the Tibia Resulting from Acute Traumatic Injuries and Complications: A Review." UNM Orthopaedic Research Journal 4, 1 (2015). https://digitalrepository.unm.edu/unm_jor/vol4/iss1/13