Case 117: Chronic Osteomyelitis and 5 cm Bone Defect Treated with Masquelet Technique Followed by Ilizarov

Reference work entry

Abstract

This case is an example of acute hematogenous osteomyelitis that progressed to chronic osteomyelitis due to a significant necrotic bone segment (secondary to a subperiosteal collection of pus). The patient was treated with multiple episodes of irrigation and debridement as well as local control via antibiotic cement beads. The Masquelet technique was then used to address the segmental bone loss. This was subsequently complicated by a pathologic stress fracture through the healed graft leading to a hypertrophic nonunion. The hypertrophic nonunion and deformity were treated via distraction with an external fixator.

Keywords

Chronic Osteomyelitis Vacuum Assisted Closure Bone Transport Soft Tissue Envelope Segmental Bone Defect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

References and Suggested Reading

  1. Anagnostakos K, Wilmes P, Schmitt E, Kelm J (2009) Elution of gentamicin and vancomycin from polymethylmethacrylate beads and hip spacers in vivo. Acta Orthop 80(2):193–197CrossRefPubMedPubMedCentralGoogle Scholar
  2. Giannoudis PV, Faour O, Goff T, Kanakaris N, Dimitriou R (2011) Masquelet technique for the treatment of bone defects: tips-tricks and future directions. Injury 42(6):591–598CrossRefPubMedGoogle Scholar
  3. Kocaoğlu M, Eralp L, Sen C, Cakmak M, Dincyürek H, Göksan SB (2003) Management of stiff hypertrophic nonunions by distraction osteogenesis: a report of 16 cases. J Orthop Trauma 17(8):543–548CrossRefPubMedGoogle Scholar
  4. Masquelet AC, Begue T (2010) The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am 41(1):27–37CrossRefPubMedGoogle Scholar
  5. Rozbruch SR, Herzenberg JE, Tetsworth K, Tuten HR, Paley D (2002) Distraction osteogenesis for nonunion after high tibial osteotomy. Clin Orthop Relat Res 394:227–235CrossRefPubMedGoogle Scholar
  6. Saleh M, Royston S (1996) Management of nonunion fractures by distraction with corrections of angulation and shortening. J Bone Joint Surg 78-B(1):105–109Google Scholar
  7. Taylor BC, French BG, Fowler TT, Russell J, Poka A (2012) Induced membrane technique for reconstruction to manage bone loss. J Am Acad Orthop Surg 20(3):142–150CrossRefPubMedGoogle Scholar
  8. Yeo A, Ramachandran M (2014) Acute haematogenous osteomyelitis in children. BMJ 348:g66CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Verdun HospitalMontrealCanada

Personalised recommendations