Corrective Intra-Articular Osteotomy Using a 3D-Printed Model and Induced Membrane Technique for AO/OTA C3 Distal Femur Fracture with Articular Malunion and Metaphyseal Nonunion

Comminuted distal femur fracture is a challenging injury, and care must be taken to reduce the articular fragment and acquire the sufficient stability for the metaphyseal comminution. We report the case of a AO/OTA C3-type distal femur fracture with articular malunion and metaphyseal nonunion. Articular malunion was treated with corrective osteotomy using a 3D-printed model for planning, and metaphyseal nonunion was treated with an induced membrane technique. Conclusion. Two major complications in the comminuted periarticular fracture can be addressed by an osteotomy and induced membrane technique. A 3D-printed model is a useful tool to evaluate the morphology of the malunited articular surface.

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Masquelet’s induced membrane technique for the reconstruction of post-traumatic, open-grade distal femur fracture with bone defect

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/2210491721992525 ◽

2021 ◽

pp. 221049172199252

Author(s):

Rameez A Musa ◽

Darshan U Shah ◽

Vipul R Makwana ◽

Arvind K Hadiya ◽

Parth K Shah ◽

...

Keyword(s):

Infection Control ◽

Bone Defect ◽

Distal Femur ◽

Femur Fracture ◽

Average Length ◽

Induced Membrane ◽

Distal Femur Fracture ◽

Membrane Technique ◽

Vascularized Fibula ◽

Induced Membrane Technique

Introduction: Reconstruction of complex, open-grade distal femur fracture with bone defect presents an orthopaedic surgeon with a distinctive challenge as they are often associated with contaminated, compromised soft tissue and poor host condition. Conventional techniques like vascularized fibula transfer, autologous bone grafting or distraction osteogenesis focus mainly over bone union without taking infection control into consideration. The aim of this study is to evaluate the outcome of induced membrane technique in the reconstruction of open distal femur fracture with bone defect. Methods: 10 such patients were retrospectively evaluated. Union was considered when a minimum of two cortices were seen on a radiograph. Knee Society Score was used to evaluate the functional outcome. Results: The average length of the defect was 5.7cm (3–10 cm) with mean interval period between the two stages being 42.7 days (34–51 days). Internal fixation was carried out in all cases. In 7 patients we used a mixture of cancellous autograft and cancellous allograft mixed in a ratio of 3:1. In the remaining 3 patients we used only cancellous autograft. Radiological union was achieved in all patients with mean union time of 8.5 months (7–11 months). Mean knee score was 79 (69–86) and mean function score was 71.5 (60–80). Conclusion: The induced membrane technique is an economical, technically less demanding technique for reconstruction of distal femur fracture with bone defects. The results are reproducible with a high success rate and without the need of any special instrumentation. It bestows infection control and prevents graft resorption. Long reconstructive period and donor site morbidity are matters of concern.

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3D‐printed, bioactive ceramic scaffold with rhBMP‐2 in treating critical femoral bone defects in rabbits using the induced membrane technique

Journal of Orthopaedic Research® ◽

10.1002/jor.25007 ◽

2021 ◽

Author(s):

Jae‐Woo Cho ◽

Beom‐Soo Kim ◽

Do‐Hyun Yeo ◽

Eic Ju Lim ◽

Seungyeob Sakong ◽

...

Keyword(s):

Bone Defects ◽

Femoral Bone ◽

Induced Membrane ◽

Ceramic Scaffold ◽

Membrane Technique ◽

Induced Membrane Technique ◽

3D Printed ◽

Bioactive Ceramic

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Full Thickness Tear of Quadriceps Tendon Associated with Closed Intra-Articular Distal Femur Fracture: A Case Report

Case Reports in Orthopedic Research ◽

10.1159/000516334 ◽

2021 ◽

pp. 131-137

Author(s):

Santanu Kar ◽

Hemant Bansal ◽

Vijay Sharma ◽

Kamran Farooque

Keyword(s):

Case Report ◽

Distal Femur ◽

Femur Fracture ◽

Femoral Fractures ◽

Quadriceps Tendon ◽

Successful Outcome ◽

Postoperative Rehabilitation ◽

Present Case Report ◽

Distal Femur Fracture ◽

Rare Association

Fractures of the supracondylar and intercondylar region of the distal femur usually result from high velocity injury that is uncommonly associated with violation of the integrity of the extensor mechanism. The consequences of missed quadriceps injury associated with a distal femur fracture are devastating. The present case report illustrates the importance of recognizing the rare association of quadriceps tear with distal femoral fractures, an appropriate surgical approach to repair the tear as well as fixation of fracture, and a protocol of postoperative rehabilitation to achieve a successful outcome.

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