Management of forearm bone loss with induced membrane technique.
Fiche publication
Date publication
mai 2020
Journal
Hand surgery & rehabilitation
Auteurs
Membres identifiés du Cancéropôle Est :
Dr GINDRAUX Florelle
Tous les auteurs :
Bourgeois M, Loisel F, Bertrand D, Nallet J, Gindraux F, Adam A, Lepage D, Sergent P, Leclerc G, Rondot T, Garbuio P, Obert L, Pluvy I
Lien Pubmed
Résumé
There are very few published studies describing the treatment of segmental bone defects of the forearm using the induced membrane technique. The objectives of this study were to evaluate the time to bone union, the function of the joints above and below the treated bone segment and the patients' quality of life over the long-term. We performed a retrospective study in all patients treated by the induced membrane for a forearm bone defect over at 13-year period. Demographics, bone union, complications, functional outcomes and occupational status were collected. Six patients were included: 2 posttraumatic injuries, 1 osteomyelitis, 1 septic arthritis, 1 aseptic nonunion, 1 tumor. The average defect length was 64mm (48-110). All defects were treated with internal fixation. Bone graft was harvested from the iliac crest in two patients, the femur (using the Reamer Irrigator Aspirator technique) in three patients and the radius in one patient. Five patients achieved bone union after a mean of 4months (3-6). Three complications were observed: 1 radioulnar instability, 1 infection of the fixation device, 1 abscess. At an average 8½ years' follow-up, the pain level on the VAS was 0.6 (0-3), the Mayo Elbow Performance Score was 98 (90-100), the Herzberg score was 108 (85.6-140) and the QuickDASH was 14.9 (2.7-35). All patients returned to work. Using the induced membrane technique avoids the complications associated with vascularized autograft and yields good functional outcome and quality of life.
Mots clés
Avant-bras, Bone loss, Consolidation, Forearm, Functional evaluation, Induced membrane, Masquelet Technique, Membrane induite, Perte de substance osseuse, Technique de Masquelet, Union, Évaluation fonctionnelle
Référence
Hand Surg Rehabil. 2020 May;39(3):171-177