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.

Infected segmental bone defects (ISBD) of the femur and tibia pose a significant challenge. Traditionally, bone fixation in the first stage of the Masquelet technique involves external fixation, but intramedullary nail fixation has recently gained popularity. Despite this, little attention has been focused on the elaboration, implantation, and removal of the spacer around the nail. In this technical note, we present gentamicin cement-coated rigid nails as definitive fixation in the first stage. We also detail the technique for placing and removing the one-piece dyed antibiotic spacer around the nail. We highlight its potential benefits in one of the critical steps of this versatile technique.