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Modified Masquelet's technique with nail and allograft: A case report.

F Niccolai¹, L Di Mento¹, M Mocchi¹

¹Department of Traumatology, IRCCS Humanitas Research Hospital, Milano, Italy.

|December 7, 2018

Summary

This study presents a modified Masquelet technique for treating large bone defects, successfully healing a 6cm femur gap in a young patient. The modified approach enabled early weight-bearing and accelerated functional recovery, demonstrating its potential in orthopaedic trauma surgery.

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Area of Science:

Orthopaedic Trauma Surgery
Regenerative Medicine
Biomaterials Science

Background:

Large bone defects pose significant challenges in orthopaedic trauma surgery.
The Masquelet technique is a common method for addressing these defects.
Septic pseudoarthrosis requires specialized treatment approaches.

Observation:

A modified Masquelet technique was employed to treat a 6cm proximal femur bone gap in an 18-year-old male with septic pseudoarthrosis.
The procedure involved a two-stage approach: initial placement of a hollow antibiotic spacer and intramedullary nail, followed by bone grafting and a new nail.
The bone graft comprised both allologous and autologous bone graft material.

Findings:

The modified technique facilitated immediate partial weight-bearing post-operatively.

Keywords:

Bone allograft Infection Intramedullary nail Masquelet Non-union

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The patient achieved complete weight-bearing within 3 months.

Fracture healing was uneventful one year after the procedure.

Implications:

This modified Masquelet technique allows for safe, immediate weight-bearing, potentially accelerating functional recovery in patients with large bone defects.
The combined use of antibiotic spacers, bone allografts, and autografts shows promise for complex fracture management.
Further research is warranted to standardize this combined technique for broader clinical application.