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Managing large bone defects in the setting of acute open fractures remains a challenging problem. We present a retrospective case series of acute lower limb open fractures with bone loss in the diaphysis, metaphysis and epiphysis addressed using the Masquelet technique. All cases present had at least 1 year follow-up with evidence of bony union and good functional outcome. Masquelet technique is both versatile and effective in managing acute open fracture with bone loss across bone regions.