The Masquelet Technique Utilizing a Graft Containment System

Description

In this presentation by Dr. Janet Conway at the Rubin Institute for Advanced Orthopedics, she discusses the treatment of a 66-year-old female pedestrian who suffered a significant injury, resulting in a 10 cm segmental tibial bone defect after being hit by a car. The patient has undergone multiple surgeries over the past eight months and is currently equipped with a temporary external fixator and a cement spacer due to a fractured fibula, along with other complications like valgus deformity and leg shortening. Dr. Conway details the surgical approach to address the bone defect, including the removal of the cement spacer, evaluation of the fibula alignment, and the potential use of a bone transport technique to fill the defect.



As the surgery progresses, she emphasizes the importance of preserving healthy bone tissue, noting robust vascularity in the tibia upon assessment. The procedure includes preparing to insert a bone rod and employing a masquelet technique to contain bone grafts during healing. Dr. Conway talks through each step, ensuring stable alignment of the leg and effectively managing the surrounding soft tissue to enhance graft integration. Additionally, she prepares to implant a biodegradable mesh to contain the autograft, ensuring the graft material remains localized without risk of shifting.



The presentation is an in-depth look at orthopedic surgical techniques focusing on complex bone reconstruction, demonstrating careful planning, technique adaptability, and attention to patient safety throughout the procedure.

DOI: 10.1302/3114-230230

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