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.
Highlights
Segmental bone defects resulting from traumatic injuries are complicated problems with significant long-term morbidity
The antibiotics used for cement spacer were either gentamicin or vancomycin
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]
Summary
Segmental bone defects resulting from traumatic injuries are complicated problems with significant long-term morbidity. Due to the difficulty in managing segmental long bone defects, amputation was the preferred treatment. Limb salvage has been developed over the last half century. The use of the Ilizarov technique, vascularized fibular grafts, and acute limb shortening have been used previously to address defects of various lengths. Traditional bone graft techniques are limited by uncontrollable graft resorption, even when the recipient site is well vascularized [3]. The use of an antibiotic cement spacer followed by grafting within this space confirmed by an induced biomembrane has been described as a potential treatment strategy [4, 5]. This paper describes a series of patients at our institution successfully treated with this technique
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