Management of twenty centimeter segmental bone defect of femoral shaft secondary to infected non-union of fracture using masquelet technique: A case report

Abstract

Introduction Segmental bone loss is a challenging condition to manage, and some of the techniques employed are difficult for patients to tolerate and involve lengthy treatment and rehabilitation times. The Masquelet technique is a two-stage bone grafting technique used to treat segmental bone defects. The technique has primarily been described for bone defects averaging 5.5 cm in length. This technique's advantages include protection against autograft resorption, relative maintenance of graft position, and prevention of soft-tissue interposition. We present a case report of a male who achieved successful bone defect union utilizing the Masquelet technique for a right femoral shaft infected non-union with a resultant 20 cm bone defect. Case report This is a case report of a 28-year old male who presented to our clinic for evaluation and treatment for a segmental bone defect secondary to a right femur fracture with non-union after infection. The patient had been in a motor vehicle collision. Our patient was interested in limb salvage surgery and declined bone transport. Given the significant size of his defect, we opted to treat him utilizing the Masquelet technique. He went on to have a successful union of his defect with associated increased subjective quality of life and functionality. Conclusion The Masquelet technique is a useful limb salvage treatment for patients with segmental bone defects, including large defects of 20 cm in length.

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.…”