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. 2019 Jan-Apr;14(1):1-5.
doi: 10.5005/jp-journals-10080-1411.

Management of Infected Nonunion of the Forearm by the Masquelet Technique

Shabir A Dhar  1 , Tahir A Dar  1 , Naseer A Mir  1
Affiliations

Management of Infected Nonunion of the Forearm by the Masquelet Technique

Shabir A Dhar et al. Strategies Trauma Limb Reconstr. 2019 Jan-Apr.

Abstract

Purpose: Infected nonunion of the forearm bones is a challenge for the orthopedic surgeon on several fronts. The forearm itself is unique as the difficulties include the relation between restoration of shaft length with the anatomy and long-term functional outcome of adjacent joints, and the risk of elbow and wrist stiffness related to prolonged immobilization. The problem of infection is complex due to the presence of bone necrosis, segmental bone loss, sinus tract formation, fracture instability, and scar adhesion of the soft tissues. The ideal management method for these situations is still debated.

Materials and methods: We used the two-stage-induced membrane technique devised by Alain Masquelet for the management of these infected nonunion of 12 forearm bones.

Results: All 12 bones united uneventfully. The bones united in a period ranging from 6 to 12 months with a mean of 7.8 months.

Conclusion: Our results show that this technique addresses several of the challenges pertinent to the forearm nonunion simultaneously and results are uniformly predictable.

How to cite this article: Dhar SA, Dar TA, Mir NA. Management of Infected Nonunion of the Forearm by the Masquelet Technique. Strategies Trauma Limb Reconstr 2019;14(1):1-5.

Keywords: Bone grafting; Infected nonunion; Masquelet technique.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1
Fig. 1
Debridement with plating. Cement has been placed in the defect. The Masquelet membrane after cement removal
Fig. 2
Fig. 2
Infected nonunion of the radius. The plate was removed and the sequestrated fragment was removed. Cement placed in the defect. Initial postoperative radiograph followed by union. Hardware was removed at 2 years follow-up. The patient did not agree to a procedure for the distal radioulnar joint as his hand function was good
Fig. 3
Fig. 3
Infected nonunion of the radius. The radiograph of the postoperative phase after the second stage bone grafting. Union at 6 months
Fig. 4
Fig. 4
Infected nonunion of the ulna. Cement placement with fixation. Grafting followed by union at 1 year follow-up
See this image and copyright information in PMC

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