{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:49:04Z","timestamp":1792522144271,"version":"4.5.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018554","name":"Science and Technology Program of Gansu Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018554","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Bone defect following debridement for calcaneal osteomyelitis presents both a clinical challenge to surgeons and a significant burden to patients. A 68-year-old male patient sustained multiple injuries, including bilateral calcaneal fractures, due to a fall from height. He underwent open reduction and internal fixation (ORIF) for bilateral calcaneal fractures and left fibular fracture at an external institution. Two months postoperatively, sinus tracts developed at the bilateral incision sites, leading to a diagnosis of bilateral calcaneal infection. The patient subsequently received multiple debridement procedures and antibiotic-loaded bone cement implantation. In our management, we performed one-stage eggshell debridement and vascularized fibular grafting immediately after removing the antibiotic-loaded bone cement. At the final follow-up, radiological evaluations revealed satisfactory graft integration and stable positioning. The postoperative Maryland Foot Score was 85 for the left foot and 90 for the right foot, indicating favorable functional recovery, with the patient reporting high satisfaction. This case suggests that one-stage eggshell debridement combined with vascularized fibular grafting, performed after the removal of antibiotic-loaded bone cement following initial debridement for calcaneal infection, can provide reliable stability and achieve favorable clinical outcomes.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1816409","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:41:31Z","timestamp":1776231691000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Eggshell debridement combined with vascularized fibular grafting for the treatment of bilateral calcaneal osteomyelitis and bone defects: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Guohai","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Linxia Pukang Hospital","place":["Linxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinshuan","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Gansu Provincial Central Hospital","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingsheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Lanzhou University Second Hospital","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Lanzhou University Second Hospital","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1177\/15347346211016696","article-title":"An effective technique for managing the calcaneus osteomyelitis combined with soft-tissue defect","volume":"22","author":"Peng","year":"2023","journal-title":"Int J Low Extrem Wounds"},{"key":"B2","doi-asserted-by":"publisher","first-page":"6810","DOI":"10.1097\/JS9.0000000000001815","article-title":"Clinical characteristics, treatment and efficacy of calcaneal osteomyelitis: a systematic review with synthesis analysis of 1118 reported cases","volume":"110","author":"Jiang","year":"2024","journal-title":"Int J Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1186\/s13018-023-04259-6","article-title":"Vacuum sealing drainage combined with eggshell-like debridement antibiotic-loaded calcium sulphate for calcaneal osteomyelitis","volume":"18","author":"Yang","year":"2023","journal-title":"J Orthop Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"9321830","DOI":"10.1155\/2018\/9321830","article-title":"A case of osteomyelitis after calcaneal fracture treated by antibiotic-containing calcium phosphate cements","author":"Kim","year":"2018","journal-title":"Case Rep Orthop"},{"key":"B5","doi-asserted-by":"publisher","first-page":"110977","DOI":"10.1016\/j.injury.2023.110977","article-title":"Using 3D printing-assisted shaping titanium cages and masquelet techniques to reconstruct calcaneal osteomyelitis complicated by extensive soft tissue and uncontrolled defects","volume":"54","author":"Zhao","year":"2023","journal-title":"Injury"},{"key":"B6","doi-asserted-by":"publisher","first-page":"342","DOI":"10.47391\/JPMA.707","article-title":"A new technique of hindfoot reconstruction in chronic calcaneal osteomyelitis using the ilizarov apparatus - a case series","volume":"72","author":"Harahsheh","year":"2022","journal-title":"J Pak Med Assoc"},{"key":"B7","doi-asserted-by":"publisher","first-page":"323","DOI":"10.7507\/1002-1892.202010064","article-title":"Simultaneous treatment of traumatic calcaneal osteomyelitis and defect deformity with near-arc bone transport by ilizarov technique","volume":"35","author":"Zhang","year":"2021","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"key":"B8","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1007\/s00590-017-2063-0","article-title":"Treatment of critical-sized bone defects: clinical and tissue engineering perspectives","volume":"28","author":"Roddy","year":"2018","journal-title":"Eur J Orthop Surg Traumatol Orthop Traumatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1097\/00006534-197505000-00002","article-title":"The free vascularized bone graft. A clinical extension of microvascular techniques","volume":"55","author":"Taylor","year":"1975","journal-title":"Plast Reconstr Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"232","DOI":"10.17392\/1306-21","article-title":"Two-stage bone-and-strut technique in the treatment of septic non-unions in the upper limb","volume":"18","author":"Meccariello","year":"2021","journal-title":"Med Glas (Zenica)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1302\/0301-620X.106B12.BJJ-2024-0219.R1","article-title":"Single-stage orthoplastic treatment of complex calcaneal osteomyelitis with large soft-tissue defects","author":"Down","year":"2024","journal-title":"Bone Jt J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1186\/s13018-018-1003-y","article-title":"Incidence and predictors of surgical site infection after ORIF in calcaneus fractures, a retrospective cohort study","volume":"13","author":"Wang","year":"2018","journal-title":"J Orthop Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"23","DOI":"10.7547\/23-092","article-title":"Vacuum-Assisted eggshell-type bone debridement with implantation of antibiotic-impregnated bone substitute for treatment of calcaneal osteomyelitis with subsequent Charcot's Reconstruction: a case report","volume":"114","author":"Yonemoto","year":"2024","journal-title":"J Am Podiatr Med Assoc"},{"key":"B14","doi-asserted-by":"publisher","first-page":"146","DOI":"10.7150\/jbji.34452","article-title":"Surgical treatment and outcomes of calcaneal osteomyelitis in adults: a systematic review","volume":"4","author":"Sabater-Martos","year":"2019","journal-title":"J Bone Jt Infect"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1007\/s43465-025-01457-8","article-title":"Calcaneal osteomyelitis: a treatment protocol","volume":"59","author":"Kulkarni","year":"2025","journal-title":"Indian J Orthop"},{"key":"B16","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/j.fas.2019.08.008","article-title":"Extensive eggshell-like debridement technique plus antibiotic-loaded calcium sulphate for one-stage treatment of chronic calcaneal osteomyelitis","volume":"26","author":"Qin","year":"2020","journal-title":"Foot Ankle Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"287","DOI":"10.17392\/1280-21","article-title":"Effectiveness of teriparatide combined with the ilizarov technique in septic tibial non-union","volume":"18","author":"Rollo","year":"2021","journal-title":"Med Glas (Zenica)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"102550","DOI":"10.1016\/j.tmaid.2023.102550","article-title":"mRNA vaccines as an armor to combat the infectious diseases","volume":"52","author":"Priyanka","year":"2023","journal-title":"Travel Med Infect Dis"},{"key":"B19","doi-asserted-by":"publisher","first-page":"5562","DOI":"10.1016\/j.vaccine.2023.07.047","article-title":"The safety and immunogenicity of a recombinant five-antigen Staphylococcus aureus vaccine among patients undergoing elective surgery for closed fractures: a randomized, double-blind, placebo-controlled, multicenter phase 2 clinical trial","volume":"41","author":"Jiang","year":"2023","journal-title":"Vaccine"},{"key":"B20","doi-asserted-by":"publisher","first-page":"113036","DOI":"10.1016\/j.injury.2026.113036","article-title":"Modified masquelet technique using free vascularized fibula grafting for reconstruction of large bone defects after bone infection","volume":"57","author":"Wang","year":"2026","journal-title":"Injury"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1816409\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:41:35Z","timestamp":1776231695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1816409\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":20,"alternative-id":["10.3389\/fsurg.2026.1816409"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1816409","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,15]]},"article-number":"1816409"}}