A case report of extensive segmental defect of the humerus treated with Masquelet technique

Infected humeral shaft nonunion treatment with the induced membrane technique and a novel fixation construct: a case report

“…5 The IMT has demonstrated successful results for defects ranging from 5 to 24 cm and in both upper and lower extremity defects for septic and aseptic nonunions. 6,7,14–19 In this case, the patient did not return for a second bone grafting procedure until 8 weeks after her first stage IMT to fully eradicate her infection. This is on the tail end of what has been described as the optimal bone grafting window and may have had an effect on the healing potential of her bone graft because she did require a secondary bone graft procedure to achieve union.…”

Extensive humeral defect secondary to humeral shaft nonunion and chronic osteomyelitis treated with induced membrane technique augmented with fibula autograft: a case report

“…In another study, the humerus was involved in two of 11 cases treated with IMT, but the maximum defect was 3 cm. 12 Litvina and Semenistyy 16 describe this technique for the management of nonunion of a diaphyseal humerus fracture, with a bone defect of approximately 12 cm, secondary to multiple surgeries, achieving consolidation with the membrane induction technique at 8 weeks after a three-stage procedure.…”

“…Most cases use an external fixator, but this is more common in lower limbs or cases with minor defects. Litvina and Semenistyy 16 used the LCP Extra-articular Distal Humerus Plate for intermediate fixation, fixing the cement spacer with a screw, which appealed as an excellent technique to us. Litvina and Semenistyy 16 explained that the ends of the cement spacer should overlay the bone ends covered by periosteum.…”

“…9 This technique replaces almost any long bone defect in a fixed amount of time. 16 This article presents a clinical case report of a patient treated with induced membrane technique augmented with fibula autograft for an 18-cm humerus shaft defect due to a pathological fracture non-union on chronic osteomyelitis. Keywords: Induce membrane technique; Masquelet; humerus non-union; chronic osteomyelitis; humeral defect; fibula autograft.…”

“…IMT allows the repair of large segmental bone defects without the application of distraction osteogenesis or microvascular surgery. 16 The IMT involves two stages. In the first stage, a polymethyl methacrylate spacer (with or without antibiotics) is placed into the bone defect to induce the formation of a vascularized membrane.…”