Neurobionplus
Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    
Login 

Users Online: 627 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 53  |  Issue : 2  |  Page : 237-245

Antibiotic cement spacer and induced membrane bone grafting in open fractures with bone loss: A case series


1 Department of Orthopaedics, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
2 Department of Plastic Surgery, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India

Correspondence Address:
Dr. Srinivas Kasha
Department of Orthopaedics, Block III, 3rd Floor, Krishna Institute of Medical Sciences, Minister Road, Secunderabad - 500 003, Telangana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ortho.IJOrtho_110_17

Rights and Permissions

Background: Open fractures are a difficult entity, often complicated by infection and nonunion. Bone loss in such fractures adds to the complexity. Conventional techniques of bone defect management are mainly directed toward fracture union but not against preventing infection or joint stiffness. In this case series, we evaluated Masquelet's technique for management of open fractures with bone loss. Materials and Methods: Twenty seven open fractures with bone defect, which presented within 3 days of trauma were planned for treatment by Masquelet's technique. Followup ranged from 21 to 60 months. Results: Average length of bone defect was 6 cm. Radiological union was obtained at a mean of 280 days since first stage of surgery. Time for union was not related to the size of defect. Union was faster in metaphyseal region (265.6 ± 38.8 days) as compared to diaphysis (300.9 ± 58.6 days). No patient had residual infection after stage 1. All the patients were able to mobilize with full weight bearing after radiological union with a satisfactory range of motion of adjacent joints. Conclusion: This technique can be routinely applied in compound fractures with bone loss with good results. Chances of infection are reduced using antibiotic cement spacer as an adjunct to thorough debridement. Induced biomembrane revascularizes the graft. Union can be expected in most of the cases, however, long time to union is a limitation. Technique is cost-effective and does not require special training or instrumentation. Although it is a two-stage surgery, requirement of multiple surgeries, as may be needed in conventional methods, is avoided.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed464    
    Printed20    
    Emailed0    
    PDF Downloaded101    
    Comments [Add]    

Recommend this journal