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骨缺損、感染、壞死，咔咔一頓清創(chuàng)之后發(fā)現(xiàn)骨頭不夠用了，咋辦？來(lái)來(lái)來(lái)，Masquelet 技術(shù)閃亮登場(chǎng)！本文整理了詳細(xì)操作步驟，供大家參考。 概述   Masquelet 技術(shù)示意圖 具體操作流程 
6 ~ 8 周后骨水泥周圍誘導(dǎo)膜形成, 確認(rèn)感染控制
  若跳過(guò)引流，則有極大的可能發(fā)生血腫，繼而導(dǎo)致植骨丟失。此階段，骨的穩(wěn)定性可通過(guò)髓內(nèi)釘或鋼板、外固定支架穩(wěn)定固定患肢來(lái)實(shí)現(xiàn)。 骨缺損愈合及負(fù)重  二期手術(shù)不論采取何種固定方式，負(fù)重的過(guò)程都應(yīng)該循序漸進(jìn)，通常為植骨后的 6 ~ 7 個(gè)月。骨缺損愈合循序漸進(jìn)，需要 1 ~ 2 年時(shí)間才能完全重建缺損的節(jié)段。 小結(jié) Masquelet 技術(shù)可以有效治療多個(gè)部位的創(chuàng)傷后骨缺損、感染性骨缺損、腫瘤切除后骨缺損、先天性脛骨假關(guān)節(jié)等。  作者：孫小六 圖源：文末文獻(xiàn) 參考文獻(xiàn) 1.Kyle Kubes;Alex Friedman;Casey Pyle;Graal Diaz;Damayea Hargett; (2021). Management of twenty centimeter segmental bone defect of femoral shaft secondary to infected non-union of fracture using masquelet technique: A case report . International Journal of Surgery Case Reports, (), –. doi:10.1016/j.ijscr.2021.106107 2.John Mukhopadhaya , Janki Sharan Bhadani （2021）.Masquelet technique for infected distal radius fractures with gaps in paediatric age group.Trauma Case Rep. 2021 Dec 8;37:100568.doi: 10.1016/j.tcr.2021.100568. 3.Andrea I. Alford;Daemeon Nicolaou;Mark Hake;Sarah McBride‐Gagyi; (2021). Masquelet's induced membrane technique: Review of current concepts and future directions . Journal of Orthopaedic Research, (), –. doi:10.1002/jor.24978 4.W R Daniel Seng , A X Rex Premchand（2021）.Application of Masquelet technique across bone regions - A case series.Trauma Case Rep. 2021 Dec 24;37:100591. doi: 10.1016/j.tcr.2021.100591. eCollection 2022 Feb. 5.SCareri , R Vitiello, M S Oliva, A Ziranu, G Maccauro, C Perisano（2019）.Masquelet technique and osteomyelitis: innovations and literature review.Eur Rev Med Pharmacol Sci. 2019 Apr;23(2 Suppl):210-216.doi: 10.26355/eurrev_201904_17495. 6.Raven, T.F.; Moghaddam, A.; Ermisch, C.; Westhauser, F.; Heller, R.; Bruckner, T.; Schmidmaier, G. (2019). Use of Masquelet technique in treatment of septic and atrophic nonunion. Injury, (), S0020138319303638–. doi:10.1016/j.injury.2019.06.018 7.Masquelet, Alain; Kanakaris, Nikolaos K.; Obert, Laurent; Stafford, Paul; Giannoudis, Peter V. (2019). Bone Repair Using the Masquelet Technique. The Journal of Bone and Joint Surgery, 101(11), 1024–1036. doi:10.2106/JBJS.18.00842 8. 骨折治療的 AO 原則第三版 9. 金嘉誠(chéng).Masquelet 技術(shù)在骨缺損修復(fù)中的應(yīng)用進(jìn)展 [J]. 中醫(yī)正骨,2019,31(6):32-34. 10.Walker, Matthew; Sharareh, Behnam; Mitchell, Scott A. (2018). Masquelet Reconstruction for Posttraumatic Segmental Bone Defects in the Forearm. The Journal of Hand Surgery, (), S0363502317319524–. doi:10.1016/j.jhsa.2018.07.003 11. 蔡成闊，舒衡生（2018）. Masquelet 技術(shù)治療骨缺損的研究進(jìn)展. 中華骨科雜志, 2018,38(3) : 186-192. 12.Saxer, F.; Eckardt, H. (2017). Rekonstruktion oss?rer Defekte mit der Masquelet-Technik; Reconstruction of osseous defects using the Masquelet technique; . Der Orthop?de, (), –. doi:10.1007/s00132-017-3443-1 13.Masquelet, Alain C. (2017). Induced Membrane Technique. Journal of Orthopaedic Trauma, 31(), S36–S38. doi:10.1097/BOT.0000000000000979 14.Giannoudis, Peter V.; Harwood, Paul J.; Tosounidis, Theodoros; Kanakaris, Nikolaos K. (2016). Restoration of long bone defects treated with the induced membrane technique: protocol and outcomes. Injury, 47(), S53–S61. doi:10.1016/S0020-1383(16)30840-3 15.Morelli, Ilaria; Drago, Lorenzo; George, David A.; Gallazzi, Enrico; Scarponi, Sara; Romanò, Carlo L. (2016). Masquelet technique: myth or reality? A systematic review and meta-analysis. Injury, 47(), S68–S76. doi:10.1016/S0020-1383(16)30842-7 16.Mauffrey, C.; Barlow, B. T.; Smith, W. (2015). Management of Segmental Bone Defects. Journal of the American Academy of Orthopaedic Surgeons, 23(3), 143–153. doi:10.5435/jaaos-d-14-00018 17.Moghaddam, Arash; Zietzschmann, Severin; Bruckner, Thomas; Schmidmaier, Gerhard (2015). Treatment of atrophic tibia non-unions according to 『diamond concept』: Results of one- and two-step treatment. Injury, 46(), S39–S50. doi:10.1016/S0020-1383(15)30017-6 18.Masquelet, Alain C.; Begue, Thierry (2010). The Concept of Induced Membrane for Reconstruction of Long Bone Defects. Orthopedic Clinics of North America, 41(1), 27–37. doi:10.1016/j.ocl.2009.07.011 19.Paul R. Stafford; Brent L. Norris (2010). Reamer-irrigator-aspirator bone graft and bi Masquelet technique for segmental bone defect nonunions: a review of 25 cases. , 41(supp-S2), 0–0. doi:10.1016/s0020-1383(10)70014-0 20.Apard; N. Bigorre; P. Cronier; F. Duteille; P. Bizot; P. Massin (2010). Two-stage reconstruction of post-traumatic segmental tibia bone loss with nailing. , 96(5), 549–553. doi:10.1016/j.otsr.2010.02.010 |
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來(lái)自： Zhaojunchao404 > 《骨科基礎(chǔ)》
