Modified Masquelet technique for the reconstruction of a 16-centimeter femoral bone defect: a case report
DOI:
https://doi.org/10.58814/01208845.75Keywords:
Osteomyelitis, Femoral Fractures, Intramedullary Nailing, Bone Lengthening, Case ReportAbstract
Introduction: Multiple options exist for the surgical treatment of bone defects (BD). Although there is no consensus on the gold standard, the induced membrane technique (Masquelet) has demonstrated good functional outcomes and union rates, especially in femoral BDs.
Case presentation: In 1990, a 68-year-old man suffered diaphyseal fractures of the left femur and femoral neck. Two years after undergoing surgery to treat these fractures, he experienced several episodes of infection in the surgical wound and eventually in the bone for 17 years. In 2009, the patient presented to the emergency department of a tertiary care clinic in Bogotá D.C. (Colombia) due to left thigh pain and fistula with pus. He was admitted to the hospital and imaging and laboratory tests were performed, with findings suggesting chronic osteomyelitis. The patient was taken to a two-stage surgery in which the Masquelet technique was used (first stage: resection of the infected bone tissue [16cm] and stabilization with intramedullary nail plus bone cement spacer; second stage: use of structural allograft mixture of condyle for reconstructing the BD), achieving a satisfactory reconstruction of the BD and a significant improvement in functionality and long-term quality of life (last follow-up: 13 years after the reconstruction of the BD).
Conclusion: In the present case, the modified Masquelet technique allowed the reconstruction of a large BD, achieving good outcomes (recovery of function and significant improvement in quality of life). Moreover, the patient did not experience any complications associated with the procedure.
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