Masquelet A C
Department of Orthopaedic and Reconstructive Surgery, Hôpital Avicenne, 125 Route de Stalingrad, 93009 Bobigny, France.
Langenbecks Arch Surg. 2003 Oct;388(5):344-6. doi: 10.1007/s00423-003-0379-1. Epub 2003 Sep 11.
We report a series of reconstructions of long bone defects in 35 patients. Bone defects ranged from 5.0 to 25.0 cm.
Reconstruction was performed in two stages. The first stage was the insertion into the defect of a cement spacer, which was responsible for the formation of a pseudosynovial membrane. A soft tissue repair employing a flap was done in the same operating time in 28 cases. The second stage was the reconstruction of the bone defect by a large, fresh, autologous cancellous bone graft.
The membrane induced by the spacer prevents the resorption of the graft and favours its revascularisation and its corticalisation. Experimental study has also shown that the membrane plays the role of an "in situ growth-factors delivery system".
In weight-bearing diaphyseal segments normal walking was possible at 8.5 months on average.
我们报告了35例长骨缺损的一系列重建手术。骨缺损范围为5.0至25.0厘米。
重建分两个阶段进行。第一阶段是在缺损处插入一个骨水泥间隔物，其负责形成假滑膜。28例在同一手术时间采用皮瓣进行软组织修复。第二阶段是用大量新鲜自体松质骨移植重建骨缺损。
间隔物诱导形成的膜可防止移植骨吸收，并有利于其血管化和皮质化。实验研究还表明，该膜起到“原位生长因子递送系统”的作用。
在负重骨干段，平均8.5个月后即可正常行走。
