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

Service de chirurgie orthopédique, traumatologique et réparatrice, hôpital Avicenne, université Paris XIII, Bobigny, France.
Annales de Chirurgie Plastique Esthétique (Impact Factor: 0.59). 07/2000; 45(3):346-53.
Source: PubMed

ABSTRACT 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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    • "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 · 2.46 Impact Factor
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    • "As a component of limb salvage surgery, they can be some of the most rewarding. French surgeon Alain-Charles Masquelet developed the two-stage technique that bears his name in the 1980s, describing results of 35 patients with diaphyseal defects ranging from 4 to 25 cm [4]. Before this, the Ilizarov method and vascularized bone transfer were the most common procedures for large diaphyseal bone defects, the former taking months longer for segmental defects, and the latter associated w/unacceptable degrees of graft resorption [5]. "
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    ABSTRACT: Cases of limb salvage following skeletal trauma involving significant bone loss pose a particular challenge to the reconstructive surgeon. Certain techniques for addressing this complex issue have been advanced in recent years and have met with considerable success. The Masquelet technique involves a staged procedure in which a temporary skeletal stabilization is paired with implantation of an antibiotic spacer and left in place for 6–8 weeks, during which time a " pseudomembrane " forms around the cement spacer. During the second stage of the procedure, the pseudomembrane is incised, the antibiotic spacer removed, and bone graft is placed. We present a case of significant segmental femur loss in a 19-year-old male opting for limb salvage in which a 17-centimeter segmental loss of bone was essentially regrown using a combination of the Masquelet technique with supplemental endosteal fixation.
    11/2014; 2015. DOI:10.1155/2015/369469
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    • "Treatment of large segmental bone defects can be challenging for orthopaedic surgeons. Masquelet et al. [6] described a procedure combining induced membranes and cancellous autografts. Bone grafting of these defects is often delayed after primary fixation to allow soft tissue healing, decrease the risk of infection, and prevent graft resorption [7]. "
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    ABSTRACT: 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.
    The Scientific World Journal 02/2014; 2014:710302. DOI:10.1155/2014/710302 · 1.73 Impact Factor
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