Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet Jun

Service de chirurgie orthopédique, traumatologique et réparatrice, hôpital Avicenne, université Paris XIII, Bobigny, France.
Annales de Chirurgie Plastique Esthétique (Impact Factor: 0.31). 07/2000; 45(3):346-53.
Source: PubMed


In the reported series of 35 cases bone reconstruction of large diaphyseal defects was performed in two stages. The first stage was the insertion into the defect of a cement spacer which was responsible for the formation of a pseudosynovial membrane. The second stage was the reconstruction of the defect by a huge fresh autologous cancellous bone graft. The membrane induced by the spacer prevents the resorption of the graft and favors its vascularity and its corticalisation. In weight bearing diaphyseal segments the normal walking was possible at 8.5 months on average. The length of the reconstructed defects was 4 to 25 cm.

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    • "A final option, also to be considered, would be the development of gap or bone defect models. Both the plate and the nail have the possibility to accommodate a larger gap, which may be particularly suitable for example in a debridement and retention experiment, or even treatment of infection by the Masquelet technique (Masquelet et al., 2000). Such studies are highly clinically relevant and achievable with the current model. "
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    ABSTRACT: The local mechanical environment at a fracture is known to influence biological factors such as callus formation, immune cell recruitment and susceptibility to infection. Infection models incorporating a fracture are therefore required to evaluate prevention and treatment of infection after osteosynthesis. The aim of this study was to create humane, standardised and repeatable preclinical models of implant-related bone infection after osteosynthesis in the rabbit humerus. Custom-designed interlocked intramedullary nails and commercially available locking plates were subjected to biomechanical evaluation in cadaveric rabbit humeri; a 10-week in vivo healing study; a dose response study with Staphylococcus aureus over 4 weeks; and finally, a long-term infection of 10 weeks in the plate model.Outcome measures included biomechanical testing, radiography, histology, haematology and quantitative bacteriology. Both implants offered similar biomechanical stability in cadaveric bones, and when applied in the in
    European cells & materials 09/2015; 30:148-162. · 4.89 Impact Factor
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    • "Masquelet published a series of thirty-five patients who underwent long bone reconstruction using a two-stage technique [2]. The first stage was the insertion of a polymethylmethacrylate cement spacer into the defect for two months. "
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    ABSTRACT: Reconstruction of critical-size bony defects remains a challenge to surgeons despite recent technological advances. Current treatments include distraction osteogenesis, cancellous autograft, induced membranes (Masquelet procedure), polymeric membranes, and titanium-mesh cages filled with bone graft. In this article, the authors presents two cases in which critical-sized defects were reconstructed using a meshed fascial autograft encasing reamer-irrigator-aspirator (RIA) autograft and cancellous allograft. This article will discuss the clinical outcomes of the technique, comparison to other current techniques, and technical insight into the potential biological mechanism.
    Patient Safety in Surgery 12/2014; 8(1):40. DOI:10.1186/s13037-014-0040-7
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    • "Injury (2014), are long periods of treatment, pain accompanying the transport, pin tract infection, reflex sympathetic dystrophy and non-union at the docking site [4] [5]. The ''induced membrane'' technique described by Masquelet et al. [6] [10] consists of two surgical steps. The first step comprises soft tissue and bone debridement with implantation of a cement spacer that induces a pseudosynovial membrane, stabilisation of the bony segment with an external fixation, and soft tissue coverage or free tissue transfer, if needed. "
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    ABSTRACT: The “induced membrane” technique described by Masquelet has been used successfully for many years for posttraumatic bone defect reconstruction, non-unions and osteomyelitis. The main advantages are the two-step surgical procedure that in case of primary infection allows repeated debridement if necessary, in case of internal fixation early weight bearing with decreased malalignment risk and it has a short learning curve. A theoretical application of this procedure is the management of acute severe traumatic bone loss of the limbs despite the lack of this experience in literature. We report on a Gustilo IIIB meta-epiphyseal fracture (AO 43-C3) of the leg with a 6 cm in length bone loss that was treated with the Masquelet technique.
    Injury 11/2014; 45. DOI:10.1016/j.injury.2014.10.033 · 2.14 Impact Factor
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