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采用诱导膜技术治疗节段性骨缺损。

Segmental Bone Defect Treated With the Induced Membrane Technique.

作者信息

Konda Sanjit R, Gage Mark, Fisher Nina, Egol Kenneth A

机构信息

*Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY; and †Jamaica Hospital Medical Center, Queens, NY.

出版信息

J Orthop Trauma. 2017 Aug;31 Suppl 3:S21-S22. doi: 10.1097/BOT.0000000000000899.

Abstract

PURPOSE

Posttraumatic bone defects in the setting of severe open injuries of the lower extremity present a significant challenge for orthopaedic trauma surgeons. The induced membrane technique, also known as the Masquelet technique, has been shown to be generally successful in achieving bony union. This video demonstrates the use of the Masquelet technique for a large (18 cm) femoral defect.

METHODS

The Masquelet technique is a 2-stage process. The first stage involves debridement of all devitalized tissue, using open reduction and internal fixation, and placement of a cement spacer with or without antibiotics. In the second stage, which is performed at least 6 weeks after the first, the spacer is removed and the resulting void is filled with bone graft.

RESULTS

This surgical case video reviews the relevant patient injury presentation, initial management, and indications for the Masquelet technique. The second stage of the Masquelet technique is featured in this video.

CONCLUSIONS

The Masquelet technique is a generally reliable method for treating large segmental bone defects. In addition, this relatively simple technique is suitable for both infected and noninfected cases.

摘要

目的

下肢严重开放性损伤后的创伤性骨缺损对骨科创伤外科医生来说是一项重大挑战。诱导膜技术,也称为Masquelet技术,已被证明在实现骨愈合方面总体上是成功的。本视频展示了Masquelet技术在治疗大尺寸(18厘米)股骨缺损中的应用。

方法

Masquelet技术分两阶段进行。第一阶段包括清除所有失活组织,采用切开复位内固定,并放置含或不含抗生素的骨水泥间隔物。第二阶段在第一阶段至少6周后进行,取出间隔物,并用骨移植填充产生的空隙。

结果

本手术病例视频回顾了相关患者的损伤表现、初始处理以及Masquelet技术的适应证。本视频展示了Masquelet技术的第二阶段。

结论

Masquelet技术是治疗大段骨缺损的一种总体可靠的方法。此外,这种相对简单的技术适用于感染和未感染的病例。

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