Reconstruction des pertes de substance osseuse diaphysaires d’origine traumatique. Stratégies, recommandations, perspectives

Management of neglected open extremity fractures in low-resource settings: Experience of the French Army Medical Service in Chad

“…The availability of antibiotics is irregular in local pharmacies and they are often too expensive for the general population. Moreover, bone reconstruction techniques require specific surgical material that is not available, and close monitoring for several months which is extremely difficult in patients from rural areas [18].…”

Right Ulnar Reconstruction after Sequestrectomy by Non-Vascularized Fibular Transfer in a Girl of Three Years

“…Our case illustrates one of its indications in the management of a bone defect after sequestrectomy for chronic osteomyelitis. Masquelet [13] [34] in France proposed it as an alternative in the second step of management in bone defect, after placement of a cement spacer in his induced membrane technique. Isolated bone transfer is the most widely used in orthopedics-traumatology [17].…”

“…The induced membrane technique with temporary interposition of an acrylic cement spacer to fill the loss of bone substance has been described by Masquelet in France [13] [34]. Acrylic cement was not available in our conditions and limited our therapeutic means, in particular not allowing us to effectively apply the Masquelet induced membrane technique.…”

“…One of the delicate sequels is the bone loss, often caused by extended diaphyseal sequestrations [12]. Bone losses cause important management problem [13] [14]. Several surgical methods have been described for bone reconstruction both in the upper limb and in the lower one: cancellous bone graft, Ilizarov's bone distraction [15] or single-stup fibula transfer [13] [14] [16] [17] [18] [19].…”

Traitement des fractures ouvertes des membres négligées en situation précaire : expérience du Service de santé des armées français au Tchad

“…Ensuite, les gestes de reconstruction osseuse nécessitent du matériel chirurgical spécifique non disponible, ainsi qu'un suivi rapproché sur de nombreux mois, difficilement envisageable pour les patients provenant des zones rurales [18]. Les séquestrectomies itératives témoignent des aléas du parage osseux dans les lésions chroniques.…”