Buffard Marius, Druel Thibault, Mathieu Laurent, Rutka Victor, Gazarian Aram, Walch Arnaud
Department of Hand and Upper Extremity Surgery, Edouard Herriot Hospital, 5 place d'Arsonval, Lyon, 69003, France.
Department of Orthopedic, Trauma and Reconstructive Surgery, Percy Military Hospital, 101 Avenue Henri Barbusse, Clamart, 92140, France.
Eur J Trauma Emerg Surg. 2025 Jan 24;51(1):41. doi: 10.1007/s00068-024-02729-y.
To report the radiological outcomes and complications of the Masquelet induced membrane technique (IMT) for acute bone reconstruction in complex hand injuries.
We retrospectively reviewed 22 patients treated primarily by the IMT for bone defect of the phalanx and/or metacarpals bones in 26 injured digits. The median bone defect length was 17 mm (IQR 13-25). Given the severity and variability of the lesions, revision parameters focused on bone healing and postoperative complications.
At the median follow-up of nine months (IQR, 6-14 months), bone union was achieved in 25 digits (96%) with a median delay of three months (IQR, 2.5-3.5 months) after stage 2. Postoperative complications occurred in 11 of 26 digits requiring revision surgery in nine of 26 digits (35%). Soft tissue coverage failure and infection were the main complications. A patient underwent a late amputation through the metacarpophalangeal joint due to an uncontrolled bone infection.
Despite a significant rate of complications, bone reconstruction using the IMT is a reliable procedure for achieving bone healing of phalanx or metacarpal bone defects in complex hand injuries.
报告Masquelet诱导膜技术（IMT）用于复杂手部损伤急性骨重建的放射学结果及并发症。
我们回顾性分析了22例主要采用IMT治疗的患者，这些患者的26个受伤手指存在指骨和/或掌骨骨缺损。骨缺损长度的中位数为17毫米（四分位间距13 - 25）。鉴于损伤的严重程度和变异性，评估指标聚焦于骨愈合情况和术后并发症。
在中位随访9个月（四分位间距，6 - 14个月）时，25个手指（96%）实现了骨愈合，二期手术后骨愈合延迟的中位数为3个月（四分位间距，2.5 - 3.5个月）。26个手指中有11个出现术后并发症，其中9个手指（35%）需要进行翻修手术。软组织覆盖失败和感染是主要并发症。一名患者因骨感染控制不佳，通过掌指关节进行了晚期截肢。
尽管并发症发生率较高，但对于复杂手部损伤中实现指骨或掌骨骨缺损的骨愈合，采用IMT进行骨重建是一种可靠的方法。
