Masquelet membrane induction technique for reconstruction of bone defect / 中华骨科杂志

ABSTRACT

There are many reasons for bone defects.Trauma,malignant tumor resection,chronic osteomyelitis and congenital factors can all lead to bone defects.The treatment methods include autogenous cancellous bone grafting,vascularized fibular grafting,distraction osteogenesis and Masquelet techniques,etc.Masquelet technique was first discovered by Masquelet et al.in 1986.It provides a simple and safe method for the treatment of large bone defects.This technique has two stages,and the first stage includes wound thoroughly debridement,maintenance of the stability of fracture,placement of (antibiotic) cement spacer,and closure of the wound without tension,then 6 to 8 weeks later,the second stage will be conducted including performing a longitudinal incision of the induced membrane,removal of the bone cement and bone graft.Bone cement includes polymethyl methacrylate (PMMA),calcium phosphate,calcium sulfate and other materials,if necessary,antibiotics could be combined at the same time.Different bone cement induced biofilmhas different characteristics.Induced membrane can secrete transforming growth factor (TGF-β1),bone morphogenetic protein 2 (BMP-2),platelet endothelial cell adhesion molecule-1 (PECAM-1),and vascular endothelial growth factor (VEGF) and other osteogenesis growth and angiogenesis related factors,then an independent space is built to isolate the bone graft from outside environment,avoiding the phenomenon of bone graft absorption and providing a stable biological environment of bone defect.Masquelet technique is simple to operate,safe,accompanied by fewer complications,less demanding to the recipient area,easy to be accepted by patients and promoted clinically.It is applicable to bone defects in all parts and has great potential for clinical application and especially suitable for large segmental bone defectwhich is ineffective in other treatment methods.