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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

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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    • "Masquelet et al. and separately Viateau et al. described these induced membranes as being 1–2 mm thick with histological properties similar to those of synovial tissue ''providing an environment favourable for bone healing''. They continue to describe the membrane as ''contributing a rich vascularisation and inhibiting soft tissue invasion into the bony defect that may potentially protect autologous bone grafts from resorption'' [3] [6]. We compared cellular constitution, histological changes, and growth factor expression in induced membranes to periosteum 2, 4 and 6 weeks after induction. "
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    ABSTRACT: The Masquelet technique for the treatment of large bone defects consists of a 2-stage procedure. In the first stage, a polymethylmethacrylate (PMMA) cement spacer is inserted into the bony defect of a rat's femur and over a period of 2–4 weeks a membrane forms that encapsulates the defect/spacer. In a second operation the membrane is opened, the PMMA spacer is removed and the resulting cavity is filled with autologous bone. Different kinds of bone cements are available, with or without supplemental antibiotics. Both might influence the development and the characteristics of the induced membrane which might affect the bone healing response. Hence, this comparative study was performed to elucidate the effect of different bone cements with or without supplemental antibiotics on the development of an induced membrane in a critical size femur defect model in rats.
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    • "Common indications for the application of the induced membrane technique are mainly aseptic, posttraumatic bone voids [14]. Also congenital pseudarthrosis of the tibia had been successfully treated [25]. "
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    ABSTRACT: Table 1. MRSA: Methicillin-resistant Staph. aureus., CNS: Coagulase-neg. Staph. epidermidis.
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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
    Full-text · Article · Sep 2015 · European cells & materials
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