Use of Masquelet Technique for the Reconstruction of Bone Defects in the Ankle. Case Report
Abstract
Segmental bone defects in the foot and ankle represent a challenge due to their anatomical characteristics, limited vascularization, and poor muscle coverage. The technique described by Masquelet has shown excellent results for the treatment of segmental bone defects in long bones. However, there are few studies in the literature on its use in the foot and ankle. The induced membrane technique offers a valid treatment alternative to solve bone defects. It allows treatment without the need for complex procedures, such as vascularized bone grafts or distraction osteogenesis, with a high rate of consolidation, preserving the length and function of the limb. Although we cannot prove that this procedure is the most indicated for the treatment of bone defects, we can affirm that all our patients have achieved consolidation, which encourages us to continue performing this same techniqueDownloads
References
Andrzejowski P, Masquelet A, Giannoudis PV. Induced membrane technique (Masquelet) for bone defects in
the distal tibia, foot, and ankle: Systematic review, case presentations, tips, and techniques. Foot Ankle Clin
;25(4):537-86. https://doi.org/10.1016/j.fcl.2020.08.013
Pelissier P, Bollecker V, Martin D, Baudet J. Foot reconstruction with the “bi-Masquelet” procedure. Ann Chir Plast Esthet 2002;47(4):304-7. https://doi.org/10.1016/s0294-1260(02)00123-1
Cattaneo R, Catagni M, Johnson EE. The treatment of infected nonunions and segmental defects of the tibia by the methods of Ilizarov. Clin Orthop Relat Res 1992;(280):143-52. PMID: 1611734
DeCoster TA, Gehlert RJ, Mikola EA, Pirela-Cruz MA. Management of posttraumatic segmental bone defects. J
Am Acad Orthop Surg 2004;12(1):28-38. https://doi.org/10.5435/00124635-200401000-00005
Obremskey WT, Molina CS, Collinge C, Tornetta P, Sagi C, Schmidt A, et al. Current practice in the management of segmental bone defects among orthopaedic trauma surgeons. J Orthop Trauma 2014;28(8):e203-7.
https://doi.org/10.1097/BOT.0000000000000034
Gaskill TR, Urbaniak JR, Aldridge JM. Free vascularized fibular transfer for femoral head osteonecrosis: donor and graft site morbidity. J Bone Joint Surg Am 2009;91(8):861-7. https://doi.org/10.2106/JBJS.H.01105
Myeroff C, Archdeancon M. Autogenous bone graft: donor sites and techniques. J Bone Joint Surg Am 2011;93(3): 222-7. https://doi.org/10.2106/JBJS.J.01513
Masquelet AC, Fitoussi F, Begue T, Muller GP. Reconstruction of the long bones by the induced membrane and
spongy autograft. Ann Chir Plast Esthet 2000;45(3):346-53. PMID: 10929461
Masquelet A, Kanakaris NK, Obert L, Stafford P, Giannoudis PV. Bone repair using the Masquelet technique. J
Bone Joint Surg Am 2019;101(11):1024-36. https;//doi.org/10.2106/JBJS.18.00842
Giannoudis PV, Faour O, Goff T, Kanakaris N, Dimitriou R. Masquelet technique for the treatment of bone defects: tips-tricks and future directions. Injury 2011;42(6):591-8. https://doi.org/10.1016/j.injury.2011.03.036
Giannoudis PV, Harwood PJ, Tosounidis T, Kanakaris NK. Restoration of long bone defects treated with the
induced membrane technique: protocol and outcomes. Injury 2016;47(Suppl 6):S53-61. https://doi.org/10.1016/S0020-1383(16)30840-3
Wong TM, Lau TW, Li X, Fang C, Yeung K, Leung F. Masquelet technique for treatment of posttraumatic bone
defects. Sci World J 2014;2014:710302. https://doi.org/10.1155/2014/710302
Mauffrey C, Hake ME, Chadayammuri V, Masquelet AC. Reconstruction of long bone infections using the induced membrane technique: Tips and tricks. J Orthop Trauma 2016;30(6):e188-93. https://doi.org/10.1097/BOT.0000000000000500
Pesciallo C, Garabano G, Montero Vinces A, Gómez DJ, Bidolegui F, Cid Casteulani A. Defectos óseos
segmentarios infectados en huesos largos: tratamiento con técnica de Masquelet. Rev Asoc Argent Ortop Traumatol 2019;84(1):15-26. https://doi.org/10.15417/issn.1852-7434.2019.84.1.853
Taylor BC, French BG, Fowler TT, Russell J, Poka A. Induced membrane technique for reconstruction to manage bone loss. J Am Acad Orthop Surg 2012;20(3):142-50. https://doi.org/10.5435/JAAOS-20-03-142
Klaue K, Knothe U, Masquelet A. Effet biologique des membranes à corps étranger induites in situ sur la
consolidation des greffes d’os spongieux. Rev Chir Orthop Suppl 1995:109-10 (70e réunion annuelle de la
SOFCOT).
Masquelet AC, Begue T. The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am 2010;41(1):27-37. https://doi.org/10.1016/j.ocl.2009.07.011
Pelissier P, Masquelet AC, Bareille R, Mathoulin Pelissier S, Amedee J. Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res 2004;22(1):73-9. https://doi.org/10.1016/S0736-0266(03)00165-7
Largey A, Faline A, Hebrard W, Hamoui M, Canovas F. Management of massive traumatic compound defects of the foot. Orthop Traumatol Surg Res 2009;95(4):301-4. https://doi.org/10.1016/j.otsr.2009.02.005
Mak MF, Stern R, Assal M. Masquelet technique for midfoot reconstruction following osteomyelitis in charcot
diabetic neuropathy: a case report. JBJS Case Connect 2015;5(2):e281-5. https://doi.org/10.2106/JBJS.CC.N.00112
Liu F, Huang RK, Xie M, Pan H, Zhao JJ, Lei B. Use of Masquelet’s technique for treating the first metatarsophalangeal joint in cases of gout combined with a massive bone defect. Foot Ankle Surg 2018;24(2):159-63. https://doi.org/10.1016/j.fas.2017.01.009
Luo F, Wang X, Wang S, Fu J, Xie Z. Induced membrane technique combined with two stage internal fixation for the treatment of tibial osteomyelitis defects. Injury 2017;48(7):1623-7. https://doi.org/10.1016/j.injury.2017.04.052
Pesciallo CA, Garabano G, Dainotto T, Ernst G. Masquelet technique in post-traumatic infected femoral and tibial segmental bone defects. Union and reoperation rates with high proportions (up to 64%) of allograft in the second stage. Injury 2021;52(11):3471-7. https://doi.org/10.1016/j.injury.2021.08.031
Karger C, Kishi T, Schneider L, Fitoussi F, Masquelet AC. Treatment of posttraumatic bone defects by the induced membrane technique. Orthop Traumatol Surg Res 2012;98:97-102. https://doi.org/10.1016/j.otsr.2011.11.001
Khan SN, Cammisa FP Jr, Sandhu HS, Diwan AD, Girardi FP, Lane JM. The biology of bone grafts. J Am
Acad Orthop Surg 2003;26:923-4. PMID: 15712985
Pelissier P, Masquelet AC, Lepreux S, Martin D, Baudet J. Behavior of cancellous bone graft placed in induced
membranes. Br J Plast Surg 2002;55:598-600. https://doi.org/10.1054/bjps.2002.3936
Siboni R, Joseph E, Blasco L, Barbe C, Bajolet O, Diallo S, et al. Management of septic non-union of the
tibia by the induced membrane technique. What factors could improve results? Orthop Traumatol Surg Res
;104(6):911. https://doi.org/10.1016/j.otsr.2018.04.013
Zoller SD, Cao LA, Smith RA, Sheppard W, Lord EL, Hamad CD, et al. Staged reconstruction of diaphyseal
fractures with segmental defects: Surgical and patient-reported outcomes. Injury 2017;48(10):2248-52.
https://doi.org/10.1016/j.injury.2017.06.018
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
