Brush Parker L, Toci Gregory R, Semenza Nicholas C, Fletcher Daniel, Beredjiklian Pedro, Aita Daren
Division of Hand Surgery, Rothman Orthopaedic Institute, Philadelphia, USA.
Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, USA.
Cureus. 2022 Jul 12;14(7):e26773. doi: 10.7759/cureus.26773. eCollection 2022 Jul.
Use of the Masquelet technique in the hand is uncommon, particularly for cases complicated by osteomyelitis. This case report describes a patient who was advised to proceed with digital amputation following the traumatic segmental bone loss with a non-salvageable distal interphalangeal joint surface complicated by osteomyelitis but refused amputation and requested alternative treatment. We suggested and performed the Masquelet procedure and arthrodesis to salvage the digit. The first stage consisted of surgical debridement and placement of an antibiotic cement spacer, and the second stage included the replacement of the antibiotic cement spacer with an iliac crest autograft and arthrodesis eight weeks after the primary procedure. The Masquelet technique led to the resolution of osteomyelitis, successful osseous union, finger ray salvage, and distal interphalangeal joint arthrodesis.
Masquelet技术在手部的应用并不常见，尤其是对于合并骨髓炎的病例。本病例报告描述了一名患者，其因创伤性节段性骨缺损且远端指间关节面无法挽救并合并骨髓炎，原本建议进行手指截肢，但患者拒绝截肢并要求替代治疗。我们建议并实施了Masquelet手术和关节融合术以挽救手指。第一阶段包括手术清创和放置抗生素骨水泥间隔物，第二阶段包括在初次手术后八周用自体髂骨移植替代抗生素骨水泥间隔物并进行关节融合术。Masquelet技术使骨髓炎得到解决，实现了成功的骨愈合，挽救了手指射线，并完成了远端指间关节融合术。
