Fig. 4

Reconstruction of an infected distal tibia defect (SOFCOT type 4) using sequential internal fixation. a Clinical and radiological view after a failed reconstruction using a composite vascularized fibula transfer. b Debridement and temporary external fixation before Masquelet technique application (stage 0). c Implantation of an 11 cm-long reinforced spacer and revision flap coverage using a pedicled cross-leg flap at stage 1. d Clinical and radiological view after division of the cross-leg flap. e Bone union after plating and bone grafting. At the last follow-up of 2 years, the functional outcome was excellent without septic recurrence. SOFCOT Société Française de Chirurgie Orthopédique et Traumatologique