Clinical study of Masquelet technique in the treatment of osteomyelitis and bone defect
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20213374Keywords:
Masquelet technique, Bone defects, Induced membrane, ReconstructionAbstract
Background: The induced membrane technique, introduced by Masquelet in 1986 called Masquelet technique is universally preferred methods of treatment in bone defect either of any cause. Consists of two principle steps: first radical debridement and filling defect with polymethylmethacrylate (PMMA) spacer, this allows the formation of induction membrane. Secondly bone cement is removed and defect is filled with bone graft and stabilized with definitive fixation.
Methods: This prospective observational study was carried out in the department of orthopedic surgery, Taihe Hospital affiliated to Hubei University of Medicine, Shiyan Hubei China from July 2018 to November 2019.
Results: Total 32 patients observed and recorded for the analysis. The mean age 38.28±11.211 years. 20 (62.5%) male and 12 (37.5%) female, 13 (40.6%) had right, and 19 (59.4%) had left side injury. Tibia has the highest involvement 16 (50%), femur 10 (31.3%), calcaneus 3 (9.4%) radius, cuboid and ulna 1 (3.1%) each. For cause of defect osteomyelitis is found to have highest frequency of 11 (34.4%). The size of defect ranges from 3 to 20 cm with mean defect (6.91±4.489 cm). Duration of bone cement ranges from 4-20 weeks with mean of 8.75±3.379 weeks. The union time ranges from 4-14 months. With mean of 8.31±2.17 months. 18 (56.3%) have excellent results, 13 (40.6%) have good results, and 1 patient (3.1%) have satisfactory results.
Conclusions: This study concludes that Masquelet technique as being the more appropriate, reliable and is a noble technique in the reconstruction of bone defect either of any cause with good functional result.
References
Wong TM, Lau TW, Li X, Fang C, Yeung K, Leung F. Masquelet technique for the treatment of posttraumatic bone defects. Sci World J. 2014.
Giannoudis P V, Faour O, Goff T, Kanakaris N, Dimitriou R. Masquelet technique for the treatment of bone defects: Tips-tricks and future directions. Injury. 2011;42(6):591-8.
Schemitsch EH. Size Matters: Defining Critical in Bone Defect Size. J Orthop Trauma. 2017;31(10):20-2.
Motsitsi NS. Masquelet’s Technique for Management of Long Bone Defects: From Experiment to Clinical Application. East Cent African J Surg. 2012;43-7.
Barlow BT, Smith W. Management of Segmental Abstract. J Am Acad Orthop Surg. 2015;23(3):143-53.
Karger C, Kishi T, Schneider L, Fitoussi F, Masquelet AC. Treatment of posttraumatic bone defects by the induced membrane technique. Orthop Traumatol Surg Res. 2012;98(1):97-102.
Azi ML, Teixeira A de AA, Cotias RB, Joeris A, Kfuri M. Induced-Membrane Technique in the Management of Posttraumatic Bone Defects. JBJS Essent Surg Tech. 2019;9(2):22.
Pelissier P, Masquelet AC, Bareille R, Mathoulin Pelissier S, Amedee J. Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res. 2004;22(1):73-9.
Lashin AM, Sc M, Mousa WF, Hosni MM. Induced Membrane (Masquelet) Technique for Treatment of Long Bone Defects. 2018;86(1):215-22.
Wang X, Wei F, Luo F, Huang K, Xie Z. Induction of granulation tissue for the secretion of growth factors and the promotion of bone defect repair. J Orthop Surg Res. 2015;10(1):4-11.
Mühlhäusser J, Winkler J, Babst R, Beeres FJP. Infected tibia defect fractures treated with the Masquelet technique. Med (United States). 2017;96(20):1-7.
Gouron R. Surgical technique and indications of the induced membrane procedure in children. Orthop Traumatol Surg Res. 2016;102(1):133-9.
Rigal S, Merloz P, Le Nen D, Mathevon H, Masquelet AC. Bone transport techniques in posttraumatic bone defects. Orthop Traumatol Surg Res. 2012;98(1):103-8.
Apard T, Bigorre N, Cronier P, Duteille F, Bizot P, Massin P. Two-stage reconstruction of post-traumatic segmental tibia bone loss with nailing. Orthop Traumatol Surg Res. 2010;96(5):549-53.
Wang X, Wang Z, Fu J, Huang K, Xie Z. Induced membrane technique for the treatment of chronic hematogenous tibia osteomyelitis. BMC Musculoskelet Disord. 2017;18(1):1-7.
Marais LC, Ferreira N. Bone transport through an induced membrane in the management of tibial bone defects resulting from chronic osteomyelitis. Strateg Trauma Limb Reconstr. 2015;10(1):27-33.
Yeganeh A, Mahmodi M, Farahini H, Moghtadaei M. Short-term Outcomes of Induced Membrane Technique in Treatment of Long Bone Defects in Iran. Med Arch (Sarajevo, Bosnia Herzegovina). 2016;70(4):284-7.
Wang X, Luo F, Huang K, Xie Z. Induced membrane technique for the treatment of bone, defects due to post-traumatic osteomyelitis. Bone Jt Res. 2016;5(3):101-5.
Qiu XS, Chen YX, Qi XY, Shi HF, Wang JF, Xiong J. Outcomes of cement beads and cement spacers in the treatment of bone defects associated with post-traumatic osteomyelitis. BMC Musculoskelet Disord. 2017;18(1):1-6.
Sivakumar R, Mohideen MG, Chidambaram M, Vinoth T, Singhi PK, Somashekar V. Management of Large Bone Defects in Diaphyseal Fractures by Induced Membrane Formation by Masquelet’s Technique. J Orthop Case Rep. 2016;6(3):59-62.