Management of Radial Shaft Nonunion with Fixation Failure Using the Masquelet Technique: A Case Report

  • Italo José Mejía Sabando Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0009-0008-4337-9061
  • Rafael Maia Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0009-0002-2613-9265
  • Raphael Wallace Campos Cunha Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0009-0003-3386-8180
  • Francisco Gabriel Mero Cañarte Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0009-0005-5403-2264
  • Kevin Marlon Armijos Montaño Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0000-0002-7246-9305
  • Jean Carlos Muñoz Macías Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0009-0000-9311-3669
Keywords: Bone graft, Masquelet technique, nonunion

Abstract

Nonunion represents a challenge for orthopedic surgeons, and although several treatment options exist, there is no clear consensus. We report the successful use of the Masquelet technique as an alternative approach. This technique, commonly used for the treatment of large bone defects in the extremities, has reported success rates ranging from 82% to 100%. Although it is widely used in the lower limbs, there is limited evidence regarding its application in the upper limbs. We present a case of radial shaft nonunion with fixation failure, successfully treated using this technique. Conclusion: Bone union was achieved at approximately 8 months, with symptom resolution and functional recovery, demonstrating the effectiveness of this therapeutic option.

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Author Biographies

Italo José Mejía Sabando, Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Rafael Maia, Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Raphael Wallace Campos Cunha, Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Francisco Gabriel Mero Cañarte, Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Kevin Marlon Armijos Montaño, Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Jean Carlos Muñoz Macías, Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
Orthopedics and Traumatology Service, Santa Casa de Misericórdia Hospital of Rio de Janeiro, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil

References

Wildemann B, Ignatius A, Leung F, Taitsman LA, Smith RM, Pesántez R, et al. Non-union bone fractures. Nat Rev Dis Primers 2021;7(1):57. https://doi.org/10.1038/s41572-021-00289-8

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. [En francés] PMID: 10929461

Micev AJ, Kalainov DM, Soneru AP. Masquelet technique for treatment of segmental bone loss in the upper extremity. J Hand Surg Am 2015;40(3):593-98. https://doi.org/10.1016/j.jhsa.2014.12.007

Kołodziejczyk K, Ropielewski A, Garlewicz R, Złotorowicz M, Czubak J. Clinical observations of the effectiveness of the Masquelet induced membrane technique in the treatment of critical long-bone defects of the lower and upper extremities. Medicina (Kaunas) 2024;60(12):1933. https://doi.org/10.3390/medicina60121933

Braswell MJ, Bulloch LR, Gaston RG, Garcia RM. Outcomes after use of the induced membrane technique for fractures of the upper extremity. J Hand Surg Am 2023;48(7):735.e1-735.e7. https://doi.org/10.1016/j.jhsa.2022.01.018

Pederiva D, de Luca L, Faldini C, Vergano LB. Masquelet’s induced membrane technique in the upper limb: a systematic review of the current outcomes. J Orthop Traumatol 2025;26(1):4. https://doi.org/10.1186/s10195-024-00815-w

Nitai K, Eran K, Yaniv, K. Radial diaphysis infected non-union treated with combination of Masquelet technique and autologous bone grafting harvested by RIA: A case report. Trauma Case Rep 2022;39:100621. https://doi.org/10.1016/j.tcr.2022.100621

O’Connor CM, Perloff E, Drinane J, Cole K, Marinello PG. An analysis of complications and bone defect length with the use of induced membrane technique in the upper limb: A systematic review. Hand 2022;17(3):572-77. https://doi.org/10.1177/1558944720918368

Zhou M, Ma Y, Jia X, Wu Y, Liu J, Wang Y, et al. Comparison of free vascularized fibular grafts and the Masquelet technique for the treatment of segmental bone defects with open forearm fractures: a retrospective cohort study. J Orthop Traumatol 2024;25(1):44. https://doi.org/10.1186/s10195-024-00787-x

Mathieu L, Bilichtin E, Durand M, de l’Escalopier N, Murison JC, Collombet JM, et al. Masquelet technique for open tibia fractures in a military setting. Eur J Trauma Emerg Surg 2020;46(5):1099-105. https://doi.org/10.1007/s00068-019-01217-y

Rohilla R, Sharma PK, Wadhwani J, Das J, Singh R, Beniwal D. Prospective randomized comparison of bone transport versus Masquelet technique in infected gap nonunion of tibia. Arch Orthop Trauma Surg 2022;142(8):1923-32. https://doi.org/10.1007/s00402-021-03935-8

Herrera Caballero ZV, Sierra Pérez M, Hernández Frías E, Ceballos Sánchez JA, de los Santos Montoya FA. Técnica de Masquelet en no unión atrófica de tibia con osteomielitis crónica, su descripción. Acta Médica Grupo Ángeles 2021;19(2):280-4. https://doi.org/10.35366/100456

Published
2026-04-30
How to Cite
Mejía Sabando, I. J., Maia, R., Campos Cunha, R. W., Mero Cañarte, F. G., Armijos Montaño, K. M., & Muñoz Macías, J. C. (2026). Management of Radial Shaft Nonunion with Fixation Failure Using the Masquelet Technique: A Case Report. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 91(2), 157-164. https://doi.org/10.15417/issn.1852-7434.2026.91.2.1981
Section
Case Presentations