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Masquelet technique

Cyril Mauffrey, Peter V Giannoudis, Janet D Conway, Joe R Hsu, Alain-Charles Masquelet
No abstract text is available yet for this article.
October 2016: Injury
Salvi Prat, Santiago Gallardo-Villares, Marian Vives, Ana Carreño, Marta Caminal, Irene Oliver-Vila, Daniel Chaverri, Margarita Blanco, Margarita Codinach, Pere Huguet, José Ramírez, Javier A Pinto, Màrius Aguirre, Ruth Coll, Joan Garcia-López, Fernando Granell-Escobar, Joaquim Vives
Pseudoarhtrosis is a relatively frequent complication of fractures, in which the lack of mechanical stability and biological stimuli results in the failure of bone union, most frequently in humerus and tibia. Treatment of recalcitrant pseudoarthrosis relies on the achievement of satisfactory mechanical stability combined with adequate local biology. Herein we present two cases of atrophic pseudoarthrosis that received a Tissue Engineering Product (TEP) composed of autologous Bone Marrow-derived Mesenchymal Stromal Cells (BM-MSC) combined with deantigenised trabecular bone particles from tissue bank...
September 29, 2016: Journal of Tissue Engineering and Regenerative Medicine
O Borens, N Helmy
BACKGROUND: Infections after osteosynthesis are a feared complication of the surgical treatment of fractures and should be dealt with by a multidisciplinary team. In addition to the surgeon, also included in this multidisciplinary team are a specialist for infectious diseases, a microbiologist, a radiologist and often a plastic surgeon. This review article describes the current knowledge on the pathogenesis, diagnostics, classification and treatment. The aim is to demonstrate some basic rules in the treatment of infections associated with implants and to show potential therpeutic approaches...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Xin Yu, Hongri Wu, Jianhua Li, Zhao Xie
PURPOSE: Recently we modified the Masquelet technique by using an antibiotic cement-coated locking plate as a temporary internal fixator when treating septic bone defects. This modification is in order to prevent the complications related to external fixator use and provides the involved limb with a greater stability to undergo earlier and more vigorous physical therapy for recovery of joint function. The purpose of this study was to assess the outcomes of large femoral osteomyelitis defects managed by Masquelet technique combined with the antibiotic cement-coated locking plate used as a temporary internal fixator...
August 13, 2016: International Orthopaedics
A Moghaddam, C Ermisch, C Fischer, S Zietzschmann, G Schmidmaier
BACKGROUND: The treatment of non-unions with large bone defects or osteitis is a major challenge in orthopedic and trauma surgery. A new concept of therapy is a two-step procedure: Masquelet technique according to the diamond concept. METHODS: Between February 2010 and June 2014, 55 patients with tibia non-unions or infections were treated in a two-step Masquelet technique in our center. The patients' average age was 48 (median 50; minimum 15-maximum 72) with an average BMI (body mass index) of 28 (27; 18-52)...
August 4, 2016: Der Orthopäde
Kyu-Hyun Yang, Yougun Won, Sang Bum Kim, Byung-Hak Oh, Young Chang Park, Sang Jin Jeong
The treatment of a large segmental defect of over 6 cm in a long bone is a challenging procedure. Treatment options include cancellous bone graft (e.g., the Masquelet technique), vascularized fibular graft (VFG), and internal bone transport (IBT) with an external fixator. These methods may be performed with intramedullary (IM) nailing or plate fixation to enhance stability or to lessen the time of external fixation. Each method has its own advantages and limitations. This study aimed to describe the advantages of additional plate augmentation and autologous bone grafting after IM nail implantation...
October 2016: Archives of Orthopaedic and Trauma Surgery
Takahiro Niikura, Sang Yang Lee, Takashi Iwakura, Masahiro Kurosaka
BACKGROUND: The Masquelet technique is a relatively new option in the management of bone defects. It consists of 2-stage surgery. At first surgery, a cement spacer is placed to fill the bone defect. After a waiting period of 6-8 weeks, a pseudo-synovial membrane is formed around the cement. The induced membrane is rich in vascularity and osteogenic activity. At second surgery, the cement is replaced with an autologous bone graft and the graft is packed in the membrane. To harvest large quantities of bone graft, the reamer irrigator aspirator (RIA) is utilized...
August 2016: Journal of Orthopaedic Trauma
Gaurav Gupta, Sohail Ahmad, Mohd Zahid, A H Khan, M K A Sherwani, Abdul Qayyum Khan
BACKGROUND: Gap nonunion of long bones is a challenging problem, due to the limitation of conventional reconstructive techniques more so if associated with infection and soft tissue defect. Treatment options such as autograft with non-vascularized fibula and cancellous bone graft, vascularized bone graft, and bone transportation are highly demanding on the part of surgeons and hospital setups and have many drawbacks. This study aims to analyze the outcome of patients with wide diaphyseal bone gap treated with induced-membrane technique (Masquelet technique)...
May 2016: Indian Journal of Orthopaedics
Matheus L Azi, Armando Augusto de A Teixeira, Ricardo B Cotias, Alexander Joeris, Mauricio Kfuri
OBJECTIVE: To evaluate the union rate of posttraumatic bone defects treated with the induced membrane technique. DESIGN: Single-center retrospective case series. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: Thirty-three patients who sustained 34 posttraumatic bone defects (19 tibia, 15 femur). INTERVENTION: Staged management using the induced membrane technique described by Masquelet...
October 2016: Journal of Orthopaedic Trauma
V Moris, F Loisel, D Cheval, L A See, A Tchurukdichian, I Pluvy, F Gindraux, J Pauchot, N Zwetyenga, L Obert
This study was a retrospective evaluation of 18 patients with traumatic bone loss affecting the fingers, hand and wrist who were treated using the induced-membrane technique. Sixteen men and two women, mean age 54years (27-74) presented a hand injury including bone loss. Sixteen patients were treated on an emergency basis and two following nonunion of their fractures. There were 13 cases of open fracture of the phalanx and 5 cases of metacarpal fractures. These patients were treated with debridement and the injuries were covered when necessary...
April 2016: Hand Surgery and Rehabilitation
Nan Jiang, Cheng-He Qin, Yun-Fei Ma, Lei Wang, Bin Yu
In addition to autologous bone graft, vascularized fibular autograft and Ilizarov bone transfer, the Masquelet technique is another effective method to reconstruct bone defects. This technique was initially proposed in 1986 and consists of two stages. At the first stage, radical debridement is required and subsequently, a polymethylmethacrylate (PMMA) cement spacer is implanted at the site of the bone defects. At the second stage, when the PMMA-induced membrane is formed 6-8 weeks later, the cement spacer is carefully removed in order to not disturb the induced membrane and the bone graft is performed to fill the bone defects...
March 2016: Biomedical Reports
Magdalena Tarchala, Edward J Harvey, Jake Barralet
Critical-sized bone defects present a significant burden to the medical community due to their challenging treatment. However, a successful limb-salvaging technique, the Masquelet Technique (MT), has significantly improved the prognosis of many segmental bone defects in helping to restore form and function. Although the Masquelet Technique has proven to be clinically effective, the physiology of the healing it induces is not well understood. Multiple modifiable factors have been implicated by various surgical and research teams, but no single factor has been proven to be critical to the success of the Masquelet Technique...
March 2016: Advanced Healthcare Materials
Barakat Sayed El-Alfy, Ayman M Ali
BACKGROUND: Surgical reconstruction of segmental skeletal defects represents a true challenge for the orthopedic surgeons. Recently, Masquelet et al. described a two-stage technique for reconstruction of bone defects, known as the induced membrane technique. The aim of this study is to assess the results of the induced membrane technique in the management of segmental skeletal defects resulting from debridement of bone infection. MATERIALS AND METHODS: Seventeen patients with segmental skeletal defects were treated in our institution by the induced membrane technique...
November 2015: Indian Journal of Orthopaedics
Christian Fischer, Julian Doll, Michael Tanner, Thomas Bruckner, Gerald Zimmermann, Lars Helbig, Bahram Biglari, Gerhard Schmidmaier, Arash Moghaddam
INTRODUCTION: Biochemical processes during bone regeneration can be analysed via quantification of peripheral serum cytokine levels. To date, serum levels of cytokines in patients treated with masquelet technique and patients with normal bone healing have not been compared. This comparison is supposed to deliver novel insights into the process of bone regeneration. Our aim was to validate this established method in the monitoring of bone regeneration after non-union treatment in masquelet technique...
February 2016: Injury
R Gouron
The induced membrane technique is now quite adaptable to segmental bone reconstruction in children. This technique is much the same as the technique used in adults. A cement spacer is interposed, and in a second operating phase, occurring 6 weeks after the interposition of the spacer, the cement is removed and a morselized corticocancellous graft is installed in the induced membrane that had formed around the cement. Graft expansion using allograft chips should not exceed 30% of the total volume. An additional autograft strut is useful in the reconstruction of long femoral or metaphyseal-diaphyseal tibial defects...
February 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ulrik Kähler Olesen, Henrik Eckardt, Per Bosemark, Anders Wallin Paulsen, Benny Dahl, Adam Hede
BACKGROUND: Segmental defects of long bones are notoriously difficult to treat. This study evaluates eight cases in which the Masquelet technique of induced membranes was used. The primary purpose was to assess the results compared to other types of bone reconstruction and share our tips and tricks to improve the outcome. METHOD: Retrospective study based on patient records and radiographs. Eight patients operated between 2011 and 2014 were included. Three had infected non-unions...
December 2015: Injury
M Miska, S Findeisen, M Tanner, B Biglari, S Studier-Fischer, P A Grützner, G Schmidmaier, A Moghaddam
METHODS: Between 2005 and 2012, 50 patients (23 female, 27 male) with nonunion of the humeral shaft were included in this retrospective study. The mean age was 51.3 years (14 to 88). The patients had a mean of 1.5 prior operations (sd 1.2;1 to 8). All patients were assessed according to a specific risk score in order to devise an optimal and individual therapy plan consistent with the Diamond Concept. In 32 cases (64%), a change in the osteosynthesis to an angular stable locking compression plate was performed...
January 2016: Bone & Joint Journal
G Schmidmaier, A Moghaddam
The percentage of delayed or non-unions after fractures of long bones depends on the individual risk profile at approximately 10 %. The current definition states that a non-union is a fracture that will not consolidate without any further intervention - independent from the treatment time. At the early stage of a non-union a conservative treatment is possible in case of an adequately stable situation. The operative treatment depends on the type of the non-union. There are one-step or two-step procedures, all according to the principles of the "diamond concept"...
December 2015: Zeitschrift Für Orthopädie und Unfallchirurgie
Christoph Nau, Caroline Seebach, Alexander Trumm, Alexander Schaible, Kerstin Kontradowitz, Simon Meier, Hubert Buechner, Ingo Marzi, Dirk Henrich
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...
February 2016: Injury
Cyril Mauffrey, Mark E Hake, Vivek Chadayammuri, Alain-Charles Masquelet
UNLABELLED: The management of posttraumatic long bone osteomyelitis remains a challenging clinical problem. A systematic approach is necessary, beginning with eradication of the infected bone and soft tissue. There are a number of options for reconstruction of the remaining bone defect, including the induced membrane technique developed by Masquelet. We describe our technique for the 2-stage treatment of long bone osteomyelitis. The first stage involves a radical debridement, stabilization of the bone with either external fixation or an antibiotic-coated intramedullary nail, and placement of a polymethylmethacrylate spacer...
June 2016: Journal of Orthopaedic Trauma
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