Slow debridement combined with hemi-Masquelet technique for post-traumatic chronic osteomyelitis calcaneal bone defect

BACKGROUND: The treatment of calcaneal osteomyelitis presents considerable challenges to orthopedic surgeons. The objective of this study was to explore an effective approach for the radical treatment of the disease and to examine a novel bone grafting strategy for better functional recovery. METHODS: Between 2021 and 2025, 9 patients with chronic calcaneal osteomyelitis were treated via slow debridement combined with the Masquelet technique using structural bone grafting. The number of debridement, complications during treatment, and recurrence rates were recorded and analyzed. Postoperative hindfoot function was assessed by using the American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot scoring system. RESULTS: All 9 (100%) patients achieved infection eradication after an average of 1.7 (range, 1-3) debridement. Preoperative infectious symptoms, including sinus tracts, redness and swelling, were generally eliminated. All patients achieved bony healing of the calcaneal defect and could tolerate full weight bearing without pain within one year after surgery. The average AOFAS ankle and hindfoot score was 93 (range, 86-100), and the calcaneal defects of all 9 patients achieved bony healing. CONCLUSIONS: Slow debridement combined with the Masquelet technique using via structural bone grafting is an effective method for treating posttraumatic chronic calcaneal osteomyelitis. The application of this technique can lead to the complete elimination of infection as well as the preservation of hindfoot function in a cost-effective manner for patients with posttraumatic chronic calcaneal osteomyelitis.