Management Of Bone Defect With Masquelet Technique

Objective: Locally missing of bone due to trauma, infection, tumor orcongenital causes called bone defect. Extremely difficult for the clinicaltreatment of bone defects, the clinical application of a number of methods,their advantages and disadvantages. Strong osteoinductive capacity sincecancellous bone transplantation. But only in less bone defects aftertransplantation, bone healing is slow and imprecise, due to the poor bloodsupply of the recipient area, can still lead to nonunion. Masquelet techniquewas first reported in1986, and was reported in English journals first appearedin2002. In this study, we managed31cases of bone defect with Masquelettechnique, to summarize efficacy as well as the advantages and disadvantagesof the technique, and provide a theoretical basis for the clinical application ofthe technique.Method:31patients with bone defect were extracted since February2011until February2013Emergency Trauma Orthopedics in our hospital.Including21males and10females, aged18-56years old, with an average of36years old. Defect segment of length1.5-10cm (average4cm), to useMasquelet treatment efficacy and complications.The treatment process is divided into two stages: first, complete resectionof inflammatory bone segment implanted bone cement clumps containingantibiotics, and the wound is closed (if necessary, use the flap). The secondstep,6-8weeks after surgery to remove bone cement clumps implantedautologous bone grafting, fractures fixed with steel plates or other methods.Postoperative medication, nursing and functional exercise consistentpostoperative dressing by the completion of the front-line experience of thedoctor, and gradually increase activity levels. Prevention of postoperativecomplications: bed during the regular daily turn over to prevent bedsores; strengthen the activities of the lower limbs, subcutaneous low molecularweight heparin to prevent deep vein thrombosis.The follow-up time of12-20months, with an average of14.5months,were analyzed by comparing the application of statistical methods.Results:31patients were followed up for12-20months, with an averageof14.5months.31cases of bone defect healing.25cases3-8months after thebone grafting (average6months) fracture healing, three cases of bone graftafter3months, no significant callus formation by bone graft again after thesurgery,4-6months (an average of5months) healing, the healing process ofthe total time for7-9months (average8months). See also inflammatory bonesegment formation in the two cases remove bone cement chain beads andsurrounding tissue infections, debridement again placed antibiotic bonecement, after six weeks to see the infection under control, the line of bonegrafting.3months after the bone graft see obvious callus formation, are in thesix months after the fracture healing. One cases of bone graft after disuseosteoporosis, after6months no significant callus formation, bone graft againcast immobilization and partial weight-bearing activities,6months to healafter the surgery, the total time for12months. All cases the average healingtime was6.5months.Conclusion: Masquelet technique to better treatment of traumatic bonedefects, relative to traditional treatment with a shorter course of treatment,healing advantages of high probability.