Pederiva Davide, De Luca Lapo, Faldini Cesare, Vergano Luigi Branca
Unità Operativa di Ortopedia e Traumatologia, APSS Trento, Largo Medaglie d'oro, 9, 38121, Trento, Italy.
IRCCS Rizzoli Orthopedic Institute, Bologna, Italy.
J Orthop Traumatol. 2025 Jan 27;26(1):4. doi: 10.1186/s10195-024-00815-w.
The Masquelet induced membrane technique is a surgical procedure that allows the reconstruction of segmental bone defects using a relatively simple approach that requires minimal resources from both the healthcare facility and the patient. Historically applied to the lower limb, this technique is gaining increasing attention in the literature for its use in the upper limb.
A systematic review of the literature was conducted using the PubMed and Google Scholar databases to identify all studies reporting the outcomes of the Masquelet induced membrane technique in the long bones of the upper limb (humerus, radius, and ulna) with a sample size of at least 3 patients. The papers had to include the length of the bone defect, a description of the protocol used for treatment, the complications of each case, and the anatomical location of the defect. The studies that did not meet the above inclusion criteria were excluded.
The search identified 1044 studies, of which 15 met the inclusion criteria. These studies described a total of 156 patients with a mean age of 42 years. The affected bone segments included the humerus in 22 cases and the forearm in 134 cases. In 108 cases, the bone defect was septic. The average defect length was 4.5 cm. PMMA was used as a spacer in all cases, with antibiotics added in 77% of them. The average time interval between the first and second phases of the procedure was 9.5 weeks, and bone union took an average of 5.5 months. The mean follow-up duration was 48 months, and the complication rate was 21%, ranging from 0% to 75%.
The Masquelet induced membrane technique is a viable surgical option for managing segmental bone defects of the upper limb. However, the complication rate remains significant. Further research is needed to identify strategies to improve the outcomes of this technique.
Level 2.
Masquelet诱导膜技术是一种外科手术方法，它采用相对简单的方式，对医疗设施和患者资源需求极少，可用于节段性骨缺损的重建。该技术过去常用于下肢，如今在文献中因其在上肢的应用而受到越来越多的关注。
使用PubMed和谷歌学术数据库对文献进行系统回顾，以确定所有报告Masquelet诱导膜技术在上肢长骨（肱骨、桡骨和尺骨）应用结果的研究，样本量至少为3例患者。论文必须包括骨缺损长度、治疗方案描述、各病例并发症以及缺损的解剖位置。不符合上述纳入标准的研究被排除。
检索到1044项研究，其中15项符合纳入标准。这些研究共描述了156例患者，平均年龄42岁。受累骨段包括22例肱骨和134例前臂。108例骨缺损为感染性。平均缺损长度为4.5厘米。所有病例均使用聚甲基丙烯酸甲酯（PMMA）作为间隔物，其中77%添加了抗生素。手术第一阶段和第二阶段之间的平均时间间隔为9.5周，骨愈合平均需要5.5个月。平均随访时间为48个月，并发症发生率为21%，范围从0%至75%。
Masquelet诱导膜技术是治疗上肢节段性骨缺损的一种可行手术选择。然而，并发症发生率仍然较高。需要进一步研究以确定改善该技术效果的策略。
2级。
