Reconstruction of tibial bone defect in new age using the old age Papineau technique: A case series

INTRODUCTION: Despite advances in treatment, chronic osteomyelitis and infected nonunion after trauma remain a challenge to the orthopaedic field. The Papineau technique, firstly described in 1973, is an alternative to treat such conditions in hospitals where microsurgery is not available, making closure of defect using flap is not feasible. We described our experience in treating patients with chronic osteomyelitis and infected non-union of tibial fractures using the Papineau technique. METHODS: We reviewed the records of patients with severe open tibial fractures with bone defects who were treated using the Papineau technique at Cipto Mangunkusumo Hospital, Jakarta, Indonesia during the period of January 2017 to August 2019. Those with diabetes mellitus, severe liver disease, or malignancies were excluded. All surgical procedures were performed by one senior orthopedic surgeon. RESULTS: A total of four subjects were enrolled in this study. All subjects were male, with a mean age of 29 ± 6.16 years of age. The mean time to granulation tissue was 21.5 ± 1.29 days, and the mean time to union was 6 ± 0 months. There were no complications. CONCLUSIONS: The Papineau technique may provide successful eradication of infection, reconstruction of bone defect, and soft-tissue closure. In addition, this technique is feasible and safe, and it could be performed in small healthcare centres.