An Experience of the Modified Masquelet Technique in Treating Segmental Metacarpophalangeal Bone Defects

摘要

Objective: The present study aimed to explore the feasibility and efficacy of the modified Masquelet technique for treating traumatic segmental metacarpophalangeal bone defects. Methods: Seven patients with traumatic segmental metacarpophalangeal defects, who were admitted from January 2015 to March 2018 and met the surgical indications, were enrolled into the present study. All patients received standardized Masquelet treatment options: In stage I, thorough debridement was performed, the bone defects were filled with antibiotic polymethyl methacrylate (PMMA) bone cement, and symptomatic treatments such as anti-infection were given after treatment. In stage II, the phalange cement was removed at 4-6 weeks after wound healing, and autologous cancellous bone grafting was performed. Results: All seven patients were followed up for 6-24 months. The fractures healed, with an average healing time of 9.3 weeks. For all patients, no infection or other complications occurred after surgery. The wounds achieved class A healing, the grafted bones were completely ossified and healed, and the operated fingers achieved finger preservation and had an ideal appearance and function. Conclusion: The modified Masquelet technique has good effects for treating traumatic segmental metacarpophalangeal bone defects. Self-designed modified hollow bone cement modules were filled in the defect sites of the metacarpophalangeal bone to induce a periosteal-like induced membrane structure. After the bone cement was removed during the second operation, an autologous cancellous bone was implanted, thereby repairing the segmental metacar-pophalangeal bone defect. This method has the characteristics of simple operation, quick healing and wide indications. Furthermore, this method is a reliable and ideal for the treatment of traumatic segmental metacarpophalangeal defects.