scholarly journals Defectos óseos segmentarios infectados en huesos largos: tratamiento con técnica de Masquelet.[Masquelet technique for the treatment of infected segmental long-bone defects]

2019 ◽  
Vol 84 (1) ◽  
pp. 15-26
Author(s):  
Germán Garabano ◽  
César Pesciallo ◽  
Alfredo Montero Vinces ◽  
Diego José Gómez ◽  
Fernando Bidolegui ◽  
...  
Keyword(s):  
Bone Defect ◽  
Average Length ◽  
Recurrent Infection ◽  
Bone Defects ◽  
Long Bone ◽  
Reconstruction Technique ◽  
Masquelet Technique ◽  
Membrane Technique ◽  
Segmental Bone ◽  
Segmental Bone Defects

Introducción: Los defectos óseos segmentarios infectados son entidades de complejo tratamiento. La técnica de Masquelet representa una alternativa para estos casos. El objetivo de este estudio retrospectivo, multicéntrico fue mostrar los resultados clínicos y radiológicos obtenidos con esta técnica de reconstrucción en defectos óseos segmentarios infectados de fémur y tibia, caracterizar los defectos tratados y describir los diferentes aspectos de la técnica quirúrgica.Materiales y Métodos: Analizamos a 24 pacientes (14 hombres y 10 mujeres; edad promedio 36.16 años [rango 18-67]) tratados con la técnica de Masquelet, operados entre 2011 y 2016. El seguimiento promedio fue de 16.5 meses (rango 12-27) desde el segundo tiempo quirúrgico. Se analizaron el hueso afectado, la longitud del defecto (en cm), el tiempo de consolidación y el control del proceso infeccioso.Resultados: La longitud del defecto óseo tratado fue, en promedio, de 5,7 cm (rango 3-12), fue superior a 4 cm en el 50% de los casos, el defecto óseo segmentario de mayor tamaño en la tibia fue de 12 cm y de 10 cm en el fémur. Se logró la consolidación ósea en todos los casos, en 4.5 meses. Un paciente presentó una recidiva del proceso infeccioso a los 12 meses de la consolidación.Conclusiones: La técnica de Masquelet o de la membrana inducida ofrece una alternativa razonable y sencilla para un problema altamente desafiante como son los defectos óseos segmentario infectados. La tasa de consolidación es superior al 90% aun en casos complejos. ABSTRACTIntroduction: Infected segmental bone defects are challenging conditions which require a complex treatment. The Masquelet technique is an alternative for these cases. The aim of this retrospective, multicenter study was to show the clinical and radiological outcomes achieved with the use of this reconstruction technique in infected femoral and tibial segmental defects in order to characterize the defects treated and describe different aspects of this surgical approach.Methods: We analyzed 24 patients (14 men and 10 women; average age 36.16 years [range 18-67]) treated with the Masquelet technique between 2011 and 2016. The average follow-up was 16.5 months (range 12-27) from the second surgical stage. We analyzed the affected bone, defect length (cm), consolidation time and infection control.Results: Average length of treated bone defect was 5.7 cm (range 3-12), exceeding 4 cm in 50% of the cases. The largest segmental bone defect was 12 cm at the tibia and 10 cm at the femur. Bone consolidation was achieved in all cases, on an average of 4.5 months. One patient presented a recurrent infection 12 months after successful consolidation.Conclusions: The Masquelet technique, or induced membrane technique, offers a reasonable and simple alternative to a highly challenging problem, such as infected segmental bone defects, achieving a consolidation rate greater than 90% even in complex cases.

Management of Segmental Bone Defects Using Masquelet Technique

2016 ◽  
Vol 2 (2) ◽  
pp. 105-108
Author(s):  
Somnath De ◽  
◽  
Nikhilesh Das ◽  
Sudipto Mukherjee ◽  
Sabyasachi Bardhan ◽  
...  
Keyword(s):  
Bone Defects ◽  
Masquelet Technique ◽  
Segmental Bone ◽  
Segmental Bone Defects

Management of segmental bone defects

2011 ◽  
Author(s):  
Stuart J.E. Matthews
Keyword(s):  
Bone Defect ◽  
Bone Defects ◽  
Open Fractures ◽  
Trauma Surgeon ◽  
Segmental Bone ◽  
Segmental Bone Defects

♦ Segmental defects are a significant, but surmountable, problem for the Trauma surgeon♦ The best results will only be achieved if all potential solutions are considered and used correctly in either: isolation; sequentially; or concurrently.♦ Failure to create a bone defect, during debridement of some open fractures, may be catastrophic. An appreciation of the techniques available to treat segmental defects is necessary to allow the surgeon to debride with confidence.

scholarly journals Combined use of the Ilizarov non-free bone plasty and Masquelet technique in patients with acquired bone defects and pseudarthrosis

2020 ◽  
Vol 26 (4) ◽  
pp. 532-538
Author(s):  
D.Yu. Borzunov ◽  
◽  
D.S. Mokhovikov ◽  
S.N. Kolchin ◽  
E.N. Gorbach ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Soft Tissues ◽  
Bone Defects ◽  
Bone Transport ◽  
Long Bone ◽  
Cement Spacer ◽  
Technical Problems ◽  
Induced Membrane ◽  
Masquelet Technique ◽  
Membrane Technique

Introduction The Masquelet induced membrane technique is effective in the management of acquired heterogeneous long bone defects and pseudarthrosis. The combination of the Masquelet technology and Ilizarov non-free bone grafting seems promising and reduces the risks of recurrence at long-term in patients with congenital pseudarthrosis. Purpose Presentation of new technological solutions that allow combining the advantages of the Ilizarov bone transport and Masquelet bone grafting in patients with acquired bone defects. Materials and methods Retrospective assessment of the results of bone reconstruction in 10 patients who were treated by a combination of Ilizarov and Masquelet bone grafting technologies to repair long bone defects after failures of previous treatment. Fragments of the biomembrane formed around the cement spacer temporarily replacing the tibial gap after resection bone defect or pseudarthrosis were examined in all patients. The studies were carried out using a Reichard sledge microtome, an AxioScope stereomicroscope and an AxioCam ICc 5 digital camera, a JSM- 840 scanning electron microscope and an INCA-200 Energy X-ray electron probe microanalyzer. Results and discussion The combined Masquelet technique and Ilizarov non-free bone plasty provide the conditions that are favorable for reparative processes of the transported fragments. After removal of the spacer, there is a tunnel formed in the interfragmental gap, the walls of which are made of the induced membrane. Bone transport is carried out without technical problems through the compromised tissues which are debrided at the time of distraction initiation, outside the scars. At the same time, there are low risks of inflammation around the transosseous elements; there is no danger of cutting and perforation of soft tissues by transported fragments. Conclusions Complete organotypic rearrangement of the distraction regenerate with the use of Ilizarov non-free bone plasty and the Masquelet technique excludes the possibility of deformities or fractures at the level of newly formed bone areas. Active distraction histogenesis ensures the closure of soft tissue defects without additional reconstructive plastic interventions. The revealed dependence of the induced membrane blood supply on the method of treatment previously used might be a criterion for predicting the treatment outcome in patients with acquired bone defects and pseudarthrosis.

scholarly journals Masquelet Technique for Treatment of Posttraumatic Bone Defects

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tak Man Wong ◽  
Tak Wing Lau ◽  
Xin Li ◽  
Christian Fang ◽  
Kelvin Yeung ◽  
...  
Keyword(s):  
Bone Defect ◽  
Treatment Strategy ◽  
Bone Grafting ◽  
Promising Result ◽  
Bone Defects ◽  
Long Bone ◽  
Cement Spacer ◽  
Masquelet Technique ◽  
Recent Treatment ◽  
Antibiotic Spacer

Masquelet technique, which is the use of a temporary cement spacer followed by staged bone grafting, is a recent treatment strategy to manage a posttraumatic bone defect. This paper describes a series of 9 patients treated with this technique of staged bone grafting following placement of an antibiotic spacer to successfully manage osseous long bone defects. The injured limbs were stabilized and aligned at the time of initial spacer placement. In our series, osseous consolidation was successfully achieved in all cases. This technique gives promising result in the management of posttraumatic bone defects.

scholarly journals Comparison between Tonifying Kidney Yang and Yin in Treating Segmental Bone Defects Based on the Induced Membrane Technique: An Experimental Study in a Rat Model

2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Zhen Shen ◽  
Zehua Chen ◽  
Xiaodong Shi ◽  
Tao Wang ◽  
Minling Huang ◽  
...  
Keyword(s):  
Bone Repair ◽  
Bone Defects ◽  
Treated Group ◽  
Control Group ◽  
Induced Membrane ◽  
Membrane Technique ◽  
The Difference ◽  
Segmental Bone ◽  
Stage 1 ◽  
Segmental Bone Defects

Tonifying kidney therapy consisting of tonifying kidney yang and yin is the basic principle of Chinese medicine in treating segmental bone defects (SBDs). Previous studies have demonstrated the presence of the differences between tonifying kidney yang and yin in bone metabolism of osteoporosis and distraction osteogenesis models. However, whether the difference between the two tonifying kidney methods in bone repair for the induced membrane (IM) technique occurs or what is the difference remain unclear. Angiogeneic-osteogenic coupling plays an important role in bone repair and the induced membrane couples angiogenesis with the later osteogenesis during the IM process. This study aimed at investigating the effects of tonifying kidney yang (total flavonoids of Rhizoma Drynariae, TFRD) and yin (plastrum testudinis extract, PTE) on angiogenesis and osteogenesis in the IM-treated SBDs. Rats of 6 mm tibia bone defect model treated with IM were divided into five groups: the control group, the model group, the tonifying kidney yang group (TFRD-treated group), the tonifying kidney yin group (PTE-treated group), and the western medicine group. At 4 weeks after insertion of the polymethylmethacrylate (PMMA), three caudal vertebrae from the tail in each rat were implanted into the 6 mm defect gap. Radiographical, histological, immunohistochemical, and immunofluorescent analyses were performed to assess bone and vessel formation at 4 or 12 weeks after insertion of the PMMA, respectively. Our results revealed that TFRD and PTE were beneficial to both angiogenesis and osteogenesis. TFRD exerted a better effect on angiogenesis than PTE and achieved a better result in stage 1 rather than in stage 2 of IM, whereas PTE was superior to TFRD in osteogenesis and achieved a better result in stage 2 instead of stage 1. Collectively, these findings elucidated the beneficial effects of tonifying kidney yang and yin on angiogenesis and osteogenesis of SBD repair during the IM process, as well as the difference that tonifying kidney yang surpasses tonifying kidney yin in angiogenesis while tonifying kidney yin outperforms tonifying kidney yang in osteogenesis, which suggests that the combination between the application of tonifying kidney yang method in stage 1 of IM and tonifying kidney yin method in stage 2 may achieve better repair efficiency.

Sign in / Sign up

Export Citation Format

Share Document