Defectos óseos segmentarios infectados en huesos largos: tratamiento con técnica de Masquelet.[Masquelet technique for the treatment of infected segmental long-bone defects]

• Garabano, Germán ^[1] ; Pesciallo, César ^[1] ; Montero Vinces, Alfredo ^[1] ; Gómez, Diego José ^[1] ; Bidolegui, Fernando ^[2] ; Casteulani, Alberto Cid ^[1]
  1. [1] Hospital Británico de Buenos Aires

     Hospital Británico de Buenos Aires

     Argentina

     
  2. [2] Hospital Sirio Libanés, ECICARO, Ciudad Autónoma de Buenos Aires, Argentina
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 84, Nº. 1, 2019, págs. 15-26
• Idioma: español
• DOI: 10.15417/issn.1852-7434.2019.84.1.853
• Títulos paralelos:
  • Masquelet technique for the treatment of infected segmental long-bone defects
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Introducción: Los defectos óseos segmentarios infectados son entidades de complejo tratamiento. La técnica de Masquelet representa una alternativa para estos casos. El objetivo de este estudio retrospectivo, multicéntrico fue mostrar los resultados clínicos y radiológicos obtenidos con esta técnica de reconstrucción en defectos óseos segmentarios infectados de fémur y tibia, caracterizar los defectos tratados y describir los diferentes aspectos de la técnica quirúrgica.Materiales y Métodos: Analizamos a 24 pacientes (14 hombres y 10 mujeres; edad promedio 36.16 años [rango 18-67]) tratados con la técnica de Masquelet, operados entre 2011 y 2016. El seguimiento promedio fue de 16.5 meses (rango 12-27) desde el segundo tiempo quirúrgico. Se analizaron el hueso afectado, la longitud del defecto (en cm), el tiempo de consolidación y el control del proceso infeccioso.Resultados: La longitud del defecto óseo tratado fue, en promedio, de 5,7 cm (rango 3-12), fue superior a 4 cm en el 50% de los casos, el defecto óseo segmentario de mayor tamaño en la tibia fue de 12 cm y de 10 cm en el fémur. Se logró la consolidación ósea en todos los casos, en 4.5 meses. Un paciente presentó una recidiva del proceso infeccioso a los 12 meses de la consolidación.Conclusiones: La técnica de Masquelet o de la membrana inducida ofrece una alternativa razonable y sencilla para un problema altamente desafiante como son los defectos óseos segmentario infectados. La tasa de consolidación es superior al 90% aun en casos complejos. 

  • English

    Introduction: Infected segmental bone defects are challenging conditions, with complex treatment. Masquelet technique represents an alternative for these cases. The aim of this retrospective, multicenter study was to show clinical and radiological outcomes with the use of this reconstruction technique in infected segmental bone defects of femur and tibia, to characterize the defects treated and to describe different aspects of surgical technique.Methods: We analyzed 24 patients (14 men and 10 women; average age 36.16 years [range 18-67]) treated with Masquelet technique between 2011 and 2016. Average follow-up was 16.5 months (range 12-27) from the second surgical stage. Affected bone, defect length (cm), consolidation time and infectious process control were analyzed.Results: Length of treated bone defect was on average 5.7 cm (range 3-12), it was higher than 4 cm in 50% of the cases. The largest segmental bone defect measured 12 cm at the tibia and 10 cm at the femur. Bone consolidation was achieved in all cases, on average, in 4.5 months. One patient presented a recurrence of the infectious process 12 months after the successful consolidation.Conclusions: Masquelet technique or induced membrane technique offers a reasonable and simple alternative to a highly challenging problem, such as infected segmental bone defects, presenting a consolidation rate greater than 90% even in complex cases. 

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