Three‐Dimensional Printing‐Assisted Masquelet Technique in the Treatment of Calcaneal Defects

Abstract

Objective The aim of the present study was to summarize the clinical efficacy of three‐dimensional (3D) printing technology combined with the Masquelet technique in the treatment of calcaneal defects. Methods From January 2018 to April 2019, 3D printing combined with induced masquelet technology was used to treat four patients with calcaneal defects, including two men and two women. The patients were aged 22–52 years old, with an average age of 36 years. There were two cases of traffic accident injuries, there was one case of a fall from height, and there was one case of crush injury. CT scans were used to reconstruct the bilateral calcaneus, mirror technology was used to construct the bone defect area, and Materialise 3‐matic software was used to design the calcaneus shaper mold and 3D print the mold. During the operation, the mold was used to shape the bone cement and fill the bone defect. In the second stage, the bone cement was removed and autologous bone was implanted to repair the bone defect. All patients were followed up to observe the effect. Results All four patients were followed up for 14 months (range, 10–18 months). There were three cases of infectious bone defects: two cases of Escherichia coli and one case of Pseudomonas aeruginosa. The 3D printed mold was used to shape the bone cement. During the operation, it was found to have a high degree of matching with the defect area of calcaneus. There is no need to adjust it again, and the wound healed well after the first stage. In the second stage of surgery, it was found that the induced membrane formed was complete and of appropriate size; the bone cement was easily removed during the operation. The fracture healing time was 3–6 months, with an average of 4 months. At the last follow up, there was no pain and the patients walked with full weight bearing. The Maryland score was 94 points (range, 88–98 points); three cases were excellent and one case was good. The AOFAS score ranged from 86 to 98, with an average of 92.8 points; three cases were excellent and one case was good. Conclusion Three‐dimensional printing technology combined with induced membrane technology is an effective approach for treating calcaneal bone defects.

An unusual case of traumatic injury to the first metatarsal a case report

“…Due to the 5cm long bone defect and Staphylococcus aureus infection, the treatment option were limited to free fibula transplantation, Masquelet technology and distraction osteogenesis [ 11 ]. For free fibula transplantation, donor site injury and microsurgical techniques need to be considered.…”

Application of allograft and absorbable screws in the reconstruction of a massive bone defect following resection of giant osteochondroma: A retrospective study

“…However, there also exist some shortcomings, such as high cost and a long learning cycle. In addition, the long-term outcomes and the remedy after the failure of 3D printing technology have not been certified clearly ( 31 ).…”

PMMA Bone Cement Composite Functions as an Adjuvant Chemotherapeutic Platform for Localized and Multi‐Window Release during Bone Reconstruction

“…[48][49][50][51] Patients are generally only partially weightbearing while the PMMA spacer is in place. [48][49][50][51] Therefore, for the application of the PMMA composite as a temporary spacer, a slightly decreased compressive strength upon implantation does not prohibit its used in this application. Additionally, since PMMA composites continually strengthen over time (see Figures S2 and S3, Supporting Information), possibly reflecting reaction of residual monomers and/or oligomers, the PMMA/10wt%CD-DOX and PMMA/15wt%CD-DOX exceed the 70 MPa threshold over time following implantation.…”

“…48 h post-fabrication, plain PMMA and PMMA/1.25wt%Free-DOX exceeded the 70 MPa threshold, whereas PMMA/15wt%CD-DOX fell slightly short of this cutoff (by 6.6 MPa). Nevertheless, weight-bearing following the placement of the temporary spacer is highly dependent upon the location of the spacer, size of the defect, and if the spacer is supported with any metallic hardware [48][49][50][51]. Patients are generally only partially weightbearing while the PMMA spacer is in place [48][49][50][51].…”

“…Nevertheless, weight-bearing following the placement of the temporary spacer is highly dependent upon the location of the spacer, size of the defect, and if the spacer is supported with any metallic hardware [48][49][50][51]. Patients are generally only partially weightbearing while the PMMA spacer is in place [48][49][50][51]. Therefore, for the application of the PMMA composite as a temporary spacer, a slightly decreased compressive strength upon implantation does not prohibit its used in this application.…”