Management Of Infected Gap Non-Union Of Long Bones By Masquelet Technique
Journal Title: National Journal of Medical and Dental Research - Year 2017, Vol 6, Issue 1
Abstract
Management of post traumatic, Primary and Secondary Infected Gap Non-Union is a challenging problem for Orthopedic Surgeons. Masquelet has proposed a technique ,using a temporary cement spacer in the significant Gap non union in preliminary stage to induce the Bio-membrane followed by delayed bone grafting inside the bio-membrane after removal of cement spacer as second stage procedure . In our study 9 patients having tibial bone defect in 5 cases and femoral bone defect in 4 cases ,6 males and 3 females between the age group of 18 years to 60 years are managed by masquelet technique during the period of April2015 to December 2017 with the mean follow up of 1½ Years. Pre requisite condition for Masquelet technique are ,Infection free, vascularised bone with defect ,an intact soft tissue coverage and relative stability furnished by appropriate fixation device .We have taken into consideration the extent Of defect, time elapsed after trauma for insertion of spacer ,duration of spacer to keep inside for induction of Bio-membrane ,Time of delayed bone grafting inside Bio-membrane & type of implant for fixation as pre-operative planning. Antibiotic impregnated cement spacer is implanted after an average of 12(4to60) weeks after accident. Prerequisite conditions required prior to insertion of spacer are achieved by thorough bone and soft tissue debridement, toileting and administration of appropriate broad spectrum antibiotics .Average bone loss was 4(3to 9) cm in tibia and 3(2to8) cm in femur. The spacer was kept inside for an average time of 7(4to10) weeks. Radiological union was observed in 8 cases after an average duration of 48(28to82) weeks. In one case union did not occur at all and it was re operated and bony union was achieved by application of illizarov ring fixator.
Authors and Affiliations
Laxmi Narayan Meena, D R Galfat
Keywords
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