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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Infected tibia defect fractures treated with the Masquelet technique.

Julia Mühlhäusser1, Jörg Winkler, Reto Babst

  • 1Department of Traumatology and Orthopedic Surgery, Kantonsspital Luzern, Switzerland.

Medicine
|May 18, 2017
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Summary

The Masquelet technique successfully treated severe open and infected tibia fractures with bone loss in 7 of 8 patients. This method involves a cement spacer to induce a membrane, followed by soft tissue reconstruction and bone grafting for fracture healing.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Regenerative Medicine

Background:

  • Open and infected tibia fractures with significant bone loss present complex treatment challenges.
  • The Masquelet technique offers a potential solution by creating an induced membrane and facilitating soft tissue coverage.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of the Masquelet technique in treating open and infected tibia fractures with segmental bone loss.
  • To describe the work-up, operative procedure, complications, and functional outcomes in a homogenous patient group.

Main Methods:

  • Retrospective study of 8 patients with open, infected tibia fractures and bone defects treated with the Masquelet technique between 2008 and 2013.
  • Prerequisites included eradicated infection, intact soft tissue, and external fixation. Evaluations included defect volume, spacer timing, and union times.
  • Reconstructive soft tissue coverage was performed when necessary. Functional outcomes were assessed using the lower limb functional index.

Main Results:

  • Seven out of 8 patients achieved clinical and radiological union after a median of 52 weeks.
  • The Masquelet spacer was in situ for a median of 12 weeks, with reconstructive soft tissue coverage required in 7 patients.
  • Full weight-bearing was achieved at a median of 16 weeks, with 4 patients requiring reoperation.

Conclusions:

  • The Masquelet technique is a viable and effective solution for managing severe open and infected tibia fractures with bone defects.
  • Despite the complexity and need for multiple interventions, the technique facilitates bone and soft tissue healing in challenging cases.