Masquelet technique in post-traumatic infected femoral and tibial segmental bone defects. Union and reoperation rates with high proportions (up to 64%) of allograft in the second stage |
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| Institution: | 1. Department of Orthopaedic and Traumatology, British Hospital of Buenos Aires, Buenos Aires Argentina;2. Scientific Advisory Committee, British Hospital of Buenos Aires, Buenos Aires Argentina;1. Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan;2. Department of Linguistics, Indiana University, Bloomington, IN, USA;3. Prehospital Emergency Care Center, Mackay Memorial Hospital, Taipei, Taiwan;4. Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, South Korea;5. Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia;6. Department of Emergency Medicine, National Taiwan University Hospital, Yunlin Branch, Douliu City, Taiwan;7. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan;1. University of Bari “Aldo Moro”. Department of Basic Medical Sciences, Neuroscience and Sense Organs. Orthopaedic and Trauma Unit, Piazza Giulio Cesare, 11. 70124. Bari, Italy;2. Orthopaedic and Trauma Unit, Humanitas Research Hospital, Milano, Italy;1. Department of Orthopedics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, People''s Republic of China;2. Department of Orthopaedics, Chongqing General Hospital, Chongqing 400021, People''s Republic of China;3. Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400022, People''s Republic of China |
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| Abstract: | Introduction The aim of this study was to describe union, reoperation and failure rates after using the induced membrane (IM) technique with ≥50% allograft over autograft to treat infected femoral and tibial segmental bone defects (SBD).Materials and methods We retrospectively analyzed patients with femoral and tibial SBD treated in our center between 2012 and 2019 using ≥50% allograft over autograft during the second stage of the Masquelet technique. We analyzed the affected bone, defect size, osteosynthesis technique used, time elapsed between the first and second stage of the technique, graft proportions, union time, reoperations, and non-union rates.Results We included 21 patients (61.90% men) with a median age of 41 (range 18-68) years. The tibia was affected in 61.90% (n:13) and the femur in 38.09% (n:8) of the cases. SBD length was 4.5 (range 3.5-14) cm. The median interval between both stages of the technique was 10 (range 6-28) weeks. The proportion of allograft used was 50 % in 10 patients, 51 to 55% in 5 patients, 56 to 59% in 4 patients, and 60 to 64% in 2. The union rate was 95.23% over a median time of 7 (range 6-12) months. There were 3 (14.28%) reoperations: 2 for relapse of infection and 1 for mechanical instability. There was one failure (4.76%). One patient presented non-union and nail break. The median follow-up after the second stage of the technique was 26 (range 13-54) months.Conclusion The use of the induced membrane technique and a high proportion of allograft (up to 64%) achieved similar union and failure rates than those reported for similar series that relied on lower allograft proportions. |
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