Establishment and characterization of the masquelet. If you continue browsing the site, you agree to the use of cookies on this website. Masquelet ac, fitoussi f, begue t, muller gp 2000 reconstruction des os longs par membrane. A rat model of the masquelet technique was developed to further characterize the biological activities of this induced membrane. Salvage of mangled upper extremity using the masquelet. Masquelet technique, which is the use of a temporary cement spacer followed by staged bone grafting, is a recent treatment strategy to manage. This report demonstrated that the masquelet technique provides reliable outcomes for septic arthritis in dip joints as well as for long bone osteomyelitis. Masquelet technique for reconstruction of extensive bone. The inducedmembrane technique, also known as the masquelet technique, has been shown to be generally successful in achieving bony union. For these reasons, the masquelet technique is the effective method for the treatment of septic arthritis in dip joints.
The induced membrane technique is now quite adaptable to segmental bone reconstruction in children. This video demonstrates the use of the masquelet technique for a large 18cm femoral defect. Recently, masquelet proposed a procedure combining induced membranes and cancellous autografts. Knochendefekte mit gelenkbeteiligung, persistierender knocheninfekt oder osteomyelitis, insuffiziente weichteildeckung im bereich des knochendefekts, osteoporose. The methods most commonly used are the vascularised fibula autograft and the ilizarov bone transfer technique. Treatment of bone loss using the masquelet technique with ria. Masquelet induced membrane technique for the surgical. Dec 02, 2014 the masquelet technique is a relatively new innovation involving the induction of a fibrous tissue membrane around the bone defect site taking advantage of the bodys foreign body reaction to the presence of a polymethylmethacrylate pmma spacer. They may be due to trauma, bone infection, congenital defects or extensive excision of malignant tumours.
Innovative strategies for the management of long bone. Treatment of posttraumatic bone defects by the induced membrane. Pdf innovative strategies for the management of long bone. Pdf masquelet technique, which is the use of a temporary cement spacer followed by staged bone grafting, is a. The masquelet defect reconstruction is a twostage technique for the treatment of large segmental bone defects. Aug 26, 2019 the induced membrane technique imt is a twostage procedure dedicated to reconstruction of bone defects of the limbs. The masquelet induced membrane technique for reconstructing large diaphyseal defects has been shown to be a promising clinical treatment, yet relatively little is known about the cellular, histological and biochemical make. Csh is an outstanding bone substitute due to its easy availability, excellent biocompatibility, biodegradability, and osteoconductivity. Whether youve loved the book or not, if you give your honest and detailed thoughts then people will find new books that are right for them. In an evolution from open bone grafting with an external fixator of papineau et al.
The masquelet induced membrane technique is based on the principle that the body reacts to the cement spacer in that it is a foreign object, thus filling the void of the defect. Snoap t, hart j, roberts j 2017 successful bone grafting via masquelet technique around a locked antibiotic nail for tibial shaft fracture with polymicrobial infection. The masquelet technique is an additional bone reconstruction method with which to sufficiently treat initially infected long bone defects in multiple operations. In pediatrics, the masquelet technique is now mainly used in the context of cancer surgery. Mar 23, 2017 the technique is very demanding and patients cooperation is critical. Oct 17, 2016 masquelet technique for management of large bone defects. Masquelet technique for the treatment of a severe acute. Staged arthrodesis using the masquelet technique for.
The masquelet technique combined with a twostage external and internal fixation has been widely accepted as a standard in the treatment of large bone defects. Reconstruction of large segmental bone defects in rabbit. 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. Knochendefekte mit gelenkbeteiligung, persistierender knocheninfekt oder osteomyelitis, insuffiziente weichteildeckung im bereich.
It is a 2stage procedure for healing of substantial bone defects, with or without the presence of infection. Masquelet technique for the treatment of bone defects. Masquelet technique for reconstruction of osseous defects. Artificial membrane induced by novel biodegradable nanofibers. Pdf the masquelet technique in the treatment of a non. Large segmental bone defects can be repaired using the masquelet technique in conjunction with autologous cancellous bone acb. Masquelet technique for open tibia fractures in a military.
Research article the masquelet technique for membrane. Towards understanding therapeutic failures in masquelet. May 15, 2019 osteitis of the fingers is a serious infection that needs early diagnosis and appropriate surgical debridement and antibiotic treatment of the infected bone. The twostage masquelet inducedmembrane technique imt consists of cement spacerdriven membrane induction followed by an autologous cancellous bone implantation in this membrane to promote large bone defect repairs. Acute masquelet technique for reconstructing bone defects. Reconstruction of extensive traumatic bone loss in children especially after gunshot injury represents a complex and challenging clinical entity with significant longterm morbidity. Pdf innovative strategies for the management of long. Successful bone grafting via masquelet technique around a. Using the bimasquelet technique and reamerirrigator. If the effects of treatments are insufficient, longterm antibiotic treatment and repeated operations could be required. This technique has been utilized successfully for diaphyseal bone loss up to 25 cm in length, without the need for a vascularized free bone graft transfer 4, 6. The masquelet technique does offer an alternative and a viable management strategy for large bone defects.
Among bone reconstruction techniques, the induced membrane technique, proposed in 1986 by masquelet, has rarely been studied or evaluated in the surgical literature. A cement spacer hifatigue bone cement, zimmer biomet, 1800. Possibility of onestage surgery to reconstruct bone defects. Download fulltext pdf download fulltext pdf masquelet technique for treatment of posttraumatic bone defects article pdf available in the scientific world journal 2014315. The healing of critical sized segmental defects is an ongoing clinical problem. Masquelet technique for management of large bone defects. Ota video library treatment of a segmental bone defect. Pdf masquelet technique for treatment of posttraumatic bone. Dec 19, 20 the masquelet defect reconstruction is a twostage technique for the treatment of large segmental bone defects. Masquelet the author of a number of acclaimed, bestselling surgical atlases has collaborated again with an awardwinning artist to produce another invaluable surgical resource. Introduction bone defects may result from a variety of causes. Innovative strategies for the management of long bone infection. Masquelet technique for reconstruction of osseous defects in. The masquelet technique represents a twostaged reconstructive procedure that overcomes several of the shortcomings in the treatment of osteomyelitis defects, particularly those located to the long bone and associated with infected andor nonviable soft tissue.
We retrospectively analyzed the outcomes of seven lower limbs of the. A common treatment strategy is the placement of an autogenous bone graft with blood vessels. The masquelet technique is a relatively new innovation involving the induction of a fibrous tissue membrane around the bone defect site taking advantage of the bodys foreign body reaction to the presence of a polymethylmethacrylate. Masquelet technique combined with microsurgical technique. Giannoudis omar faour thomas goff nikolaos kanakaris rozalia dimitriou. The masquelet technique for septic arthritis of the small. It is a 2stage procedure for healing of substantial bone defects, with or without the presence of. Amputation was discussed but declined by the patient. The masquelet technique was first described in 2000 to treat diaphyseal defects up to 25 cm in the tibia. Establishment and characterization of the masquelet induced. Using the bimasquelet technique and reamerirrigatoraspirator for posttraumatic foot reconstruction lanie k. The firststage surgery includes radical debridement of bone and soft tissues, followed by implantation of a polymethylmethacrylate pmma cement spacer at the.
Generally asymptomatic, the pseudarthrosis of the clavicle can cause aesthetic issues and functional. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. The induced membrane technique imt is a twostage procedure dedicated to reconstruction of bone defects of the limbs. Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. Masquelet technique for treatment of posttraumatic bone. The first stage involves thorough bone and soft tissue debridement, insertion of a polymethylmethacrylate cement spacer into the defect, and stabilization of the limb. Since masquelet presented the concept of induced membrane and applied the induced membrane technique masquelet technique, the 2stage masquelet technique has been used for long bone defects, even infected long bone defects and nonunion, achieving satisfactory efficacy. This highly regarded team provide a masterclass in.
The masquelet technique for septic arthritis of the small joint in the hands. Other readers will always be interested in your opinion of the books youve read. Request pdf on nov 18, 2014, mario ronga and others published masquelet technique for the treatment of a severe acute tibial bone loss find, read and cite all the research you need on researchgate. Jun 26, 2019 large segmental bone defects can be repaired using the masquelet technique in conjunction with autologous cancellous bone acb. The masquelet technique is an innovative technique involving the induction of a fibrous tissue membrane around the. Fannouch g, alfaisali s, bobseit a, bayounis a 2018 masquelet technique for reconstruction of extensive bone defect of tibia after gunshot injury in a child. We report on a gustilo iiib metaepiphyseal fracture ao 43c3 of the leg with a 6 cm in length bone loss that was treated with the masquelet technique.
Masquelet conceived and developed an original reconstruction technique for large diaphyseal bone defects, based on the notion of the induced a pseudomembrane, this. It involves creating a biomembrane using a pmma cement spacer within the defect. Research article the masquelet technique for membrane induction and the healing of ovine critical sized segmental defects chris christou, rema a. There are pertinent clinical questions that clinicians need to ask when applying the technique. Masquelet reconstruction for posttraumatic segmental bone. This highly regarded team provide a masterclass in the demonstration of surgically relevant anatomy. Some kind of small or acute fractures can be cured but the risk is greater for large fractures like compound fractures. First developed in the late 1970s by ac masquelet but only recently popularized. Masquelet technique for reconstruction of the ankle. Osteitis of the fingers is a serious infection that needs early diagnosis and appropriate surgical debridement and antibiotic treatment of the infected bone. When is the correct time for the patient to bear full weight especially in those where a. The masquelet technique is another effective way to repair extensive bone defects. In the former situation, a thorough debridement of the infected site is necessary to achieve a clean cavity. A retrospective study was performed among the patients treated via imt for tibial.
Possibility of onestage surgery to reconstruct bone. When is the correct time for the patient to bear full weight especially in. The masquelet technique represents a lengthindependent, twostaged reconstruction that involves the induction of a periosteal membrane and use of an antibioticimpregnated cement spacer for the treatment of. Surgical technique and indications of the induced membrane. 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.
Stryker trauma ag bohnackerweg 1, ch2545, switzerland fig. The masquelet technique represents a lengthindependent, twostaged reconstruction that involves the induction of a periosteal membrane and use of an antibiotic. However, the shortcomings of this technique include a long healing time and potential risk of failure. Pdf masquelet technique for treatment of posttraumatic. Subsequently, 68 weeks later the cement spacer is removed and the space with the biomembrane is packed with autogenous bone grafting harvested using.
The technique is very demanding and patients cooperation is critical. Artificial membrane induced by novel biodegradable. The masquelet technique in the healing of critical sized. 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. This membrane presents high concentrations of growth factors and is highly vascularized, making it ideal thanks to its osteogenic and osteoinductive factors. Request pdf on nov 18, 2014, mario ronga and others published masquelet technique for the treatment of a severe acute tibial bone loss find, read. A firststage excision of the ununited area, 8cms in length, was undertaken and an external fixator applied hoffmann ii. Generally asymptomatic, the pseudarthrosis of the clavicle can cause aesthetic issues and functional symptoms indicating a surgical repair. We report herein an acute masquelet technique for reconstructing bone defects of open lower limb fractures as the primary treatment in the acute phase.
Congenital pseudarthrosis of the clavicle treated by. In worst cases, some patients may have to undergo amputation. Usually discovered during the first months of life, cpc is characterised by a definitive bone defect in the middle third of the clavicle. Recently, the usefulness of the masquelet technique in. Masquelet technique for reconstruction of the ankle following. The patients in this study demonstrated clinical healing and bone union. Masquelet technique for treatment of posttraumatic bone defects. Osteoclasts and their precursors are present in the. The objective of this report was to evaluate employment of the imt for the treatment of open tibia fractures managed in a military trauma center treating both wartime and peacetime injuries. Treatment of bone loss using the masquelet technique with. Posttraumatic long bone osteomyelitis ptom is a relatively frequent occurrence in patients with severe open fractures and requires treatment to prevent limbthreatening complications. The masquelet technique was first performed in 1986.
Congenital pseudarthrosis of the clavicle cpc is a very rare pathology of which over 200 cases have been reported. Walsh surgical and orthopaedic research laboratories, university of new south wales australia, sydney, new south wales, australia c. Masquelet technique for the treatment of acute osteomyelitis of the pip joint caused by clenchedfist human bite injury. The masquelet technique for membrane induction and the. For the first time, this study aims at correlating imt failures with physiological alterations of the induced membrane im in patients. There is no single current technique that is reliably successful in the management of large bone defects.
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