Functional and radiographic evaluation of the treatment of traumatic bone loss of the hand using the Masquelet technique

Moris, Vivien; Loisel, François; Cheval, Damien; See, Leslie-Ann; Tchurukdichian, Alain; Pluvy, I.; Gindraux, Florelle; Pauchot, J.; Zwetyenga, N.; Obert, L.

doi:10.1016/j.hansur.2015.11.002

Cited by 33 publications

(19 citation statements)

References 37 publications

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“…Originally, the technique was described for infected gap nonunions with occasional application in cases of open fractures. In recent literature, there are a few cases reported, describing use of this technique in acute traumatic bone loss 1718. Encouraging results from our case series allude that it can be routinely used for such cases.…”

Section: Discussionmentioning

confidence: 56%

Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Fractures with Bone Loss: A Case Series

Kasha

Rathore

Kumar

2019

IJOO

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Background:Open fractures are a difficult entity, often complicated by infection and nonunion. Bone loss in such fractures adds to the complexity. Conventional techniques of bone defect management are mainly directed toward fracture union but not against preventing infection or joint stiffness. In this case series, we evaluated Masquelet's technique for management of open fractures with bone loss.Materials and Methods:Twenty seven open fractures with bone defect, which presented within 3 days of trauma were planned for treatment by Masquelet's technique. Followup ranged from 21 to 60 months.Results:Average length of bone defect was 6 cm. Radiological union was obtained at a mean of 280 days since first stage of surgery. Time for union was not related to the size of defect. Union was faster in metaphyseal region (265.6 ± 38.8 days) as compared to diaphysis (300.9 ± 58.6 days). No patient had residual infection after stage 1. All the patients were able to mobilize with full weight bearing after radiological union with a satisfactory range of motion of adjacent joints.Conclusion:This technique can be routinely applied in compound fractures with bone loss with good results. Chances of infection are reduced using antibiotic cement spacer as an adjunct to thorough debridement. Induced biomembrane revascularizes the graft. Union can be expected in most of the cases, however, long time to union is a limitation. Technique is cost-effective and does not require special training or instrumentation. Although it is a two-stage surgery, requirement of multiple surgeries, as may be needed in conventional methods, is avoided.

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Section: Discussionmentioning

confidence: 56%

Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Fractures with Bone Loss: A Case Series

Kasha

Rathore

Kumar

2019

IJOO

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“…In a retrospective assessment, Moris et al. [ 10 ] also reported the functional and X-ray results of a series of 18 patients treated for the loss of bone matter from the hand and wrist, with 16 successes and two failures.…”

Section: Discussionmentioning

confidence: 99%

Management of second metacarpal chronic osteomyelitis by induced membrane technique

Tabib

Haddad

2018

Case Reports in Plastic Surgery and Hand Surgery

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“…Complex traumatic injuries of the hand structures must be properly reconstructed to restore normal function. 1 In cases of severe osseous metacarpal injury, functional recovery is dependent on the precise distribution of tendon tension throughout the full range of motion. Due to the scale of the bones in the hand, small changes in length have greater impacts on moment arms and tendon tension of the metacarpal joints.…”

Section: Introductionmentioning

confidence: 99%

Predicting metacarpal length using paired ratios with bilateral X-ray films

et al. 2021

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Introduction: When the metacarpal bones sustain severe osseous injury requiring reconstruction, functional recovery relies on the precise distribution of tension throughout full range of motion. While the small scale of hand structures compounds the effects of altering normal anatomy, literature lacks consensus recommendations for the acceptable degree of length alteration and/or appropriate methods of length estimation in reconstructive procedures. Length asymmetry has been reported in human metacarpal bones; however, studies assessing this phenomenon in living subjects with attention to functional implications or length prediction are lacking. Methods: Hand X-rays were obtained for 34 patients aged 25–80 without history of metacarpal trauma, joint degeneration, or pathologic bone metabolism. A scaled bivariate model predicted metacarpal length using an ipsilateral paired metacarpal and matching contralateral ratio: Estimate_Dx_R = Median_Dy_R * (Median_Dx_L/Median_Dy_L). A second set of predictions used the contralateral metacarpal as a control. Pearson correlation coefficients, paired t-tests, and chi-square tests evaluated the symmetry between bilateral metacarpal lengths and paired metacarpal ratios as well as the accuracy of each predictive method. Results: The contralateral control and target metacarpal differed significantly in digits 1, 2, 3, and 5. No significant difference in matched metacarpal ratios of the right and left hands was found. For all digits except 5D, bivariate model predictions generated were more strongly correlated with actual target length. Chi-square tests did not detect a significant difference in predictive value of the two models. Conclusion: The scaled bivariate model we describe may be useful and economic in generating accurate length estimates of metacarpals for reconstructive procedures.

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Functional and radiographic evaluation of the treatment of traumatic bone loss of the hand using the Masquelet technique

Cited by 33 publications

References 37 publications

Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Fractures with Bone Loss: A Case Series

Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Fractures with Bone Loss: A Case Series

Management of second metacarpal chronic osteomyelitis by induced membrane technique

Predicting metacarpal length using paired ratios with bilateral X-ray films

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