Fig. 3

The right hand of a 46-year male patient was crushed by a machine, resulting in open fractures with nerve, vessel, and soft tissue defects. A, Preoperative X-ray. B, X-ray at four months postoperatively, indicating posttraumatic osteomyelitis in his fourth metacarpal. C, After the sinus was removed, the bone defect was filled with antibiotic PMMA cement, and the cement was fabricated into a cylindrical shape similar to the shape of the metacarpal. Four transverse and parallel Kirschner wires were placed for fixation with the adjacent metacarpal. D, At 8 weeks postoperatively, the cement spacer was removed, and the bone graft was carved into a 2 cm⋅ 1 cm ⋅ 1 cm cylindrical shape similar to the shape of the metacarpal. Two crossed Kirschner wires were used to fix the fracture. E, At eight weeks postoperatively, bone graft union was observed without additional infection