The Clinical Application of Masquelet Technique in the Treatment of Large Segmental Infective Phalanges or Metacarpal Defects

ZHAO Li-ning; TIAN Qing-ye; WANG Jian-guo

Abstract：Objective:To study effect of large segmental bone defects of phalanges(metacarpal) with Masquelet technique.Method:From January 2008 to January 2013,21 cases were therapied by Masquelet technique,with skin flap or not.All cases were infected after a debridement or internal fixation,including 13 cases of Staphylococcus aureus infection,7 cases of streptococcal infection,and 1 case of Pseudomonas aeruginosa infection.Masquelet technique involved a two-step procedure.First,bone cement was used to fill the bone defect after a thorough debridement;then the bone cement was removed after 6-8 weeks,and rich cancellous bone was implanted into the bone defect.Repairing the length of bone defect was vary from 11 mm to 33 mm(average 19 mm).Result:20 cases were cured with the clinical application of Masquelet technique,1 case was failed,due to an re-infection after the first surgery,then underwent debridement, thumb shortening and arthrodesis.18 cases were followed up,2 cases were lost.The average follow-up times were 7 months.In the 18 cases,3 cases of bone defect fingers were repaired with side flap,18 cases of wound skin were healing in 10 to 15 days,bone healing times were from 2.6 to 3.5 months(average 2.8 months), the recovery of function in fingers were all satisfactory.Conclusion:Masquelet technique is an effective method to repair large segmental infective phalanges or metacarpal defects.