GUNSHOT INDUCED HUMERUS FRACTURE TREATED USING THE MASQUELET TECHNIQUE

Abstract

Humerus fractures secondary to gunshot injury are slow to unite and may require multiple surgeries to obtain union. 1We report a gunshot induced humerus fracture treated via the Masquelet technique.Report:A 27-year old gentleman had a shotgun injury to his left arm exposing the humerus bone. He underwent debridement and external fixator and a 4cm segmental bone loss was noted. The following debridement, a humeral nail and 3cm acute shortening was done, as well as the 1st stage Masquelet (Figure 1). After 6 weeks, the 2nd stage Masquelet was performed (Figure 2). At 1 year follow up, radiographical union was noted (Figure 3).Figure 1Figure 2Figure 3Discussion:Masquelet technique consists of cement spacer insertion which is then exchanged with autologous cancellous bone graft packed into an induced membrane. 2To our knowledge, there have not been reported cases of Masquelet technique used to treat shotgun induced open humerus fractures. The use of an external fixator is proposed by many authors1. The key to success is a thorough debridement of the fracture3.Conclusion:The Masquelet technique is a reliable tool in the surgeon’s armamentarium in the management of humeral segmental bone defects2.Reference: Management of shotgun induced open fractures of the humerus with Ilizarov fixator;2015The Masquelet Technique for Thumb Metacarpal Reconstruction Following Trauma ; JBJS; 2018Muscle reconstruction in reconstructive surgery: soft tissue repair and long bone reconstruction; 2003