Tudor Razvan Cosmin, Timofte Daniel Vasile, Forna Norin, Badulescu Oana Viola, Savin Liliana, Pinteala Tudor, Mihailescu Dan, Ciobotariu Tudor, Ciobica Alin, Sirbu Mihnea Theodor, Sirbu Paul Dan, Dragosloveanu Serban, Capitanu Bogdan Sorin, Cergan Romica, Scheau Cristian
Department of Orthopedics and Traumatology, Surgical Science (II), Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
"Dr. Iacob Czihac" Military Emergency Clinical Hospital, 700483 Iasi, Romania.
Life (Basel). 2025 Mar 25;15(4):537. doi: 10.3390/life15040537.
Chronic osteomyelitis is a persistent infection of the bone that poses significant challenges, particularly when associated with pathological fractures and extensive bone defects. This case report highlights the application of Masquelet's induced membrane technique (MIMT) in managing a complex distal femur defect in a 50-year-old male with a long-standing history of chronic osteomyelitis. The patient presented with a non-union fracture, severe osseous destruction, and infection, requiring a multidisciplinary approach.
The first stage involved radical debridement of necrotic tissue and stabilization with a titanium plate and an antibiotic-impregnated polymethylmethacrylate spacer to induce a bioactive membrane. The second stage, performed 30 days later, after infection resolution, entailed removing the spacer, harvesting an autologous iliac crest bone graft, and filling the defect within the preserved membrane. Postoperative care included a tailored antibiotic regimen and gradual weight-bearing, leading to favorable clinical and radiological outcomes.
This case demonstrates the utility of MIMT in reconstructing extensive bone defects while addressing infection. The technique provides a reliable and effective alternative to amputation, offering high success rates and functional restoration in complex cases.
慢性骨髓炎是一种持续存在的骨感染,带来了重大挑战,尤其是当它与病理性骨折和广泛的骨缺损相关时。本病例报告强调了马斯克莱诱导膜技术(MIMT)在治疗一名患有长期慢性骨髓炎病史的50岁男性复杂股骨远端缺损中的应用。该患者出现骨折不愈合、严重骨质破坏和感染,需要多学科方法治疗。
第一阶段包括彻底清除坏死组织,并用钛板和含抗生素的聚甲基丙烯酸甲酯间隔物进行固定,以诱导形成生物活性膜。第二阶段在30天后进行,待感染得到控制后,取出间隔物,采集自体髂骨骨移植,并在保留的膜内填充缺损。术后护理包括定制的抗生素治疗方案和逐步负重,从而取得了良好的临床和影像学结果。
本病例证明了MIMT在重建广泛骨缺损并解决感染问题方面的实用性。该技术为截肢提供了一种可靠且有效的替代方法,在复杂病例中成功率高且能实现功能恢复。