StaffordPR.NorrisBL.Reamer-irrigator-aspirator bone graft and bi Masquelet technique for segmental bone defect nonunions: a review of 25 cases.
GaskillTR.UrbaniakJR.AldridgeJM III.Free vascularized fibular transfer for femoral head osteonecrosis: donor site and graft site morbidity.
J Bone Joint Surg Am91:
Treatment of posttraumatic bone defects by the induced membrane technique.
Orthop Traumatol Surg Res98:
Masquelet technique for the treatment of bone defects: tips-tricks and future directions.
Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration.
J Orthop Res22:
Reconstruction of large bone defects of the metatarsals, whether resulting from trauma, infection, or a neoplastic process, can be especially challenging when attempting to maintain an anatomical parabola and basic biomechanical stability of the forefoot. We present the case of a 42-year-old man with no significant medical history who presented to the emergency department following a severe lawnmower injury to the left forefoot resulting in a large degloving type injury along the medial aspect of the left first ray extending to the level of the medial malleolus. The patient underwent emergent debridement with application of antibiotic bone cement, external fixation, and a negative-pressure dressing. He was subsequently treated with split-thickness skin graft and iliac crest tricortical autograft using a locking plate construct for reconstruction of the distal first ray. Although the patient failed to advance to radiographic osseous union, clinically there was no motion at the attempted fusion site and no pain with ambulation, suggestive of a pseudoarthrosis. The patient has since progressed to full nonpainful weightbearing in regular shoes and has returned to normal activities of daily living. The patient returned to his preinjury level of work and has had complete resolution of all wounds including his split-thickness skin graft donor site. This case shows the potential efficacy of the Masquelet technique for spanning significant traumatic bone defects of the metatarsals involving complete loss of the metatarsophalangeal joint.
Corresponding author: Nathaniel L. P. Preston, DPM, PSC 482 Box 2511, FPO, AP 96362. (E-mail: email@example.com)