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Review
. 2015 Oct 14:9:32.
doi: 10.1186/s13037-015-0079-0. eCollection 2015.

Innovative strategies for the management of long bone infection: a review of the Masquelet technique

Vivek Chadayammuri  1 , Mark Hake  2 , Cyril Mauffrey  3
Affiliations
Review

Innovative strategies for the management of long bone infection: a review of the Masquelet technique

Vivek Chadayammuri et al. Patient Saf Surg. .

Abstract

Post-traumatic long bone osteomyelitis (PTOM) is a relatively frequent occurrence in patients with severe open fractures and requires treatment to prevent limb-threatening complications. The Masquelet technique represents a length-independent, two-staged reconstruction that involves the induction of a periosteal membrane and use of an antibiotic-impregnated cement spacer for the treatment of segmental bone loss that result from bone infection. In this review, we summarize recent developments regarding the diagnosis and treatment of long bone PTOM, with a special emphasis on the use of the Masquelet technique for reconstruction of wide diaphyseal defects.

Keywords: Antibiotic; Defects; Diaphyseal; Fixation; Masquelet; ORIF; Osteomyelitis; Posttraumatic; Reconstruction.

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Figures

Fig. 1
Fig. 1
Preoperative clinical photograph demonstrating an anterior wound with exposed bone
Fig. 2
Fig. 2
Preoperative lateral radiograph demonstrating a mid-diaphyseal comminuted fracture of the right tibia and sequestrum (red arrow)
Fig. 3
Fig. 3
Intra-operative photograph of the self-induced periosteal membrane during the second stage of reconstruction following removal of the cement spacer. A cement coated antibiotic nail was placed to provide bone stability and allow early weight bearing
Fig. 4
Fig. 4
Postoperative MRI of the tibia following definitive fixation with radiolucent antibiotic-impregnated carbon-fiber IM nailing. Use of the carbon-fiber IM nail enables artifact-free MRI visualization
Fig. 5
Fig. 5
Standard AP (a) and lateral (b) plain radiograph taken at 5 months postoperative follow-up demonstrating improved bone healing without evidence of osteolysis, infection, or hardware migration
See this image and copyright information in PMC

References

    1. Gallie WE. First recurrence of osteomyelitis eighty years after infection. J Bone Joint Surg Br. 1951;33-b(1):110–1. - PubMed
    1. Patzakis MJ, Zalavras CG. Chronic posttraumatic osteomyelitis and infected nonunion of the tibia: current management concepts. J Am Acad Orthop Surg. 2005;13(6):417–27. - PubMed
    1. Calhoun JH, Manring MM, Shirtliff M. Osteomyelitis of the long bones. Semin Plast Surg. 2009;23(2):59–72. doi: 10.1055/s-0029-1214158. - DOI - PMC - PubMed
    1. Ikpeme IA, Ngim NE, Ikpeme AA. Diagnosis and treatment of pyogenic bone infections. Afr Health Sci. 2010;10(1):82–8. - PMC - PubMed
    1. Sanders J, Mauffrey C. Long bone osteomyelitis in adults: fundamental concepts and current techniques. Orthopedics. 2013;36(5):368–75. doi: 10.3928/01477447-20130426-07. - DOI - PubMed