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Is Masquelet Technique A Successful Viable Treatment In Reconstructing Large Tumor Bone Gaps in Adolescent and Adult?

作者信息

Sharma Amit, Sharma Ankur, Tomar Shekhar, Mishra Abhishek, Kashyap Abhishek, Maini Lalit

机构信息

Lady Hardinge Medical College, Delhi, India.

Maulana Azad Medical College, Delhi, India.

出版信息

Arch Bone Jt Surg. 2023;11(5):348-355.


DOI:
PMID:37265531
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10231922/
Abstract

OBJECTIVES: The reconstruction of large bony defect caused by tumor resection can be managed by different technique like bone graft, Masquelet technique, mega-prosthesis etc. Literature lacks studies discussing Masquelet technique in tumor cases especially pertaining to infected tumor in adults. We aimed to determine 1) How often and how fast is the bone healing achieved after resection greater than 10 cm bone in tumour patient's using Masquelet technique?, 2) Whether Masquelet technique can achieve optimum outcomes in adult infected cases too? METHODS: We reviewed 154 patients of benign & malignant tumour managed by us between 2013 and 2019. Patients belonging to all the age group with infected tumor/diaphysial tumor/periarticular tumor, where single stage surgery or mega-prosthesis is not a viable option and were treated with Masquelet technique for reconstructing a bone defect of at least 10 cm were included in our study. We evaluated outcomes of eight patients for four parameters i.e. bony union, healing index, number of re-do surgeries required and limb length discrepancy. RESULTS: Mean age of our study group was 20.25 years and patients followed for mean duration of 3.36 years. Mean bone loss after tumor resection was 13.1 cm (range = 11.5 cm to 15 cm). There was no sign of recurrence of tumor in any patient at the time of last follow up. Average time required to achieve bony union was 23.25 months (mean healing index of 1.67 months/cm). All but one patient achieved bony union. Mean limb length discrepancy seen was 1.44cm. Infected cases showed low healing index with higher percentage of re-do surgeries. CONCLUSION: Induced membrane technique is quick, safe and reliable alternative method of reconstruction to mega-prosthesis in cases with all age group where risk of failure of mega-prosthesis is high, either due to infection or shorter expected lifespan of prosthesis. However, obtaining union can be a difficult preposition in infected tumor cases and multiple surgeries may be required to get the desired result even after two stages. However, a comparative study with large sample size is required to further validate our results.

摘要

相似文献

[1]
Is Masquelet Technique A Successful Viable Treatment In Reconstructing Large Tumor Bone Gaps in Adolescent and Adult?

Arch Bone Jt Surg. 2023

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[3]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Comparison of survival, function and complication between intercalary frozen autograft versus massive allograft reconstruction after malignant bone tumors resection.

J Orthop Traumatol. 2024-11-24

[2]
Is intercalary frozen autograft augmented with intramedullary cement and bridging plates fixation a durable reconstruction?

J Orthop Surg Res. 2024-11-10

[3]
Management of Infected Segmental Bone Defects with Antibiotic-Cement-Coated Nails in the First Stage of the Masquelet Technique. Implantation and Removal of the Cement Spacer around the Nail: A Technical Note.

Arch Bone Jt Surg. 2024

[4]
Mechanisms of the Masquelet technique to promote bone defect repair and its influencing factors.

Chin J Traumatol. 2025-5

[5]
Joint-Sparing Resection around the Knee for Osteosarcoma: Long-Term Outcomes of Biologic Reconstruction with Vascularized Fibula Graft Combined with Massive Allograft.

Cancers (Basel). 2024-4-26

[6]
Intercalary Resection of the Tibia for Primary Bone Tumors: Are Vascularized Fibula Autografts With or Without Allografts a Durable Reconstruction?

Clin Orthop Relat Res. 2024-3-21

本文引用的文献

[1]
Masquelet technique and osteomyelitis: innovations and literature review.

Eur Rev Med Pharmacol Sci. 2019-4

[2]
Success rate and risk factors of failure of the induced membrane technique in children: a systematic review.

Injury. 2016-12

[3]
Management of segmental skeletal defects by the induced membrane technique.

Indian J Orthop. 2015

[4]
Surgical technique and indications of the induced membrane procedure in children.

Orthop Traumatol Surg Res. 2016-2

[5]
Preliminary Results of the Induced Membrane Technique for the Reconstruction of Large Bone Defects.

J Pediatr Orthop. 2017-1

[6]
Is the Induced-membrane Technique Successful for Limb Reconstruction After Resecting Large Bone Tumors in Children?

Clin Orthop Relat Res. 2015-6

[7]
Proximal femoral reconstruction with a constrained acetabulum in oncologic patients.

Orthopedics. 2014-2

[8]
Bone defect reconstruction in children using the induced membrane technique: a series of 14 cases.

Orthop Traumatol Surg Res. 2013-9-23

[9]
Induced-membrane femur reconstruction after resection of bone malignancies: three cases of massive graft resorption in children.

Orthop Traumatol Surg Res. 2013-4-19

[10]
Induced membrane technique for reconstruction after bone tumor resection in children: a preliminary study.

Orthop Traumatol Surg Res. 2012-4-5

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