doi: 10.1055/s-0040-1710336.
eCollection 2022 Dec.
Management of Bone Failure in Fracture of the Distal Region of the Femur Using the Masquelet Technique with Fibula Graft Associated with Iliac-Crest Graft: Report of Two Cases
Affiliations
- PMID: 36540751
- PMCID: PMC9757967
- DOI: 10.1055/s-0040-1710336
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Management of Bone Failure in Fracture of the Distal Region of the Femur Using the Masquelet Technique with Fibula Graft Associated with Iliac-Crest Graft: Report of Two Cases
Rev Bras Ortop (Sao Paulo).
.
Abstract
Two cases of bone failure after fracture of the distal region of the femur treated with the Masquelet technique are presented. The first case involves acute bone loss, and the second, pseudarthrosis. The proper management of these lesions led to consolidation and a good functional result.
Keywords: bone graft; femur fractures; pseudarthrosis.
Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).
Conflict of interest statement
Conflito de Interesses Os autores declaram não haver conflito de interesses.
Figures
(
A
) Anteroposterior (AP) radiograph of the knee demonstrating bone failure. (
B
) Computed tomography (CT) coronal section demonstrating bone loss and a small joint fragment of the lateral femoral condyle and (
C
) a sagittal cut of an associated Hoffa fracture.
(
A
and
B
) Anteroposterior (AP) and profile radiographs demonstrating bone failure filled with orthopedic cement and fixation of joint fragments and medial blocked plate. (
C
) Vascularized membrane after cement removal – tip of the clamp. (
D
) Bone failure filled with fibula graft and iliac-crest graft.
(
A
and
B
) Anteroposterior (AP) and profile radiographs demonstrating bone consolidation. (
C
and
D
) Final range of motion.
(
A
and
B
) Anteroposterior (AP) radiographs and computed tomography (CT) scans demonstrating unfeasible bone segment and pseudarthrosis of the distal region of the femur. (
C
and
D
) Devitalized bone tissue removed and defect filled with orthopedic cement with antibiotics and fixation with lateral blocked plate (X-ray).
(
A
) Vascularized-fibula autologous graft (arrow – blood vessel ). (
B
and
C
) Postoperative radiograph demonstrating consolidation. (
D
) Range of motion.
(
A
) Radiografia em incidência anteroposterior (AP) do joelho demonstrando falha óssea. (
B
) Tomografia computadorizada (TC) em corte coronal demonstrando perda óssea e pequeno fragmento articular do côndilo femoral lateral, e (
C
) em corte sagital de fratura de Hoffa associada.
(
A
e
B
) Radiografias em incidências anteroposterior(AP) e de perfil demonstrando falha óssea preenchida com cimento ortopédico e fixação dos fragmentos articulares, e placa bloqueada medial. (
C
) Membrana vascularizada após a remoção do cimento – ponta da pinça. (
D
)Falha óssea preenchida com enxerto de fíbula e de crista ilíaca.
(
A
e
B
) Radiografias em incidências anteroposterior(AP) e de perfil demonstrando consolidação óssea. (
C
e
D
) Amplitude de movimento final.
(
A
e
B
) Radiografias em incidência anteroposterior(AP) e tomografia computadorizada (TC) demonstrando segmento ósseo inviável e pseudoartrose da região distal do fêmur. (
C
e
D
) Tecido ósseo desvitalizado removido, e defeito preenchido com cimento ortopédico, com antibiótico e fixação com placa bloqueada lateral (raio X, RX).
(
A
) Enxerto autólogo de fíbula vascularizada (seta – vaso sanguíneo). (
B
e
C
) Radiografia pós-operatória demonstrando a consolidação. (
D
) Amplitude de movimento.
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