Masquelet’s Technique for Management of Long Bone Defects: From Experiment to Clinical Application

Abstract

Bone defect, of whatever cause, is clinically challenging to treat. Defects of up to 4.0 cm can be successfully treated with cancellous bone grafting. Large defects require more complex
alternatives like, bone transport, vascularized bone grafting, allografts or fibular pro-tibia grafting. There are advantages and disadvantages to these techniques and patient’s cooperation is critical for successful outcome. None of these treatment options are reliably successful. The Masquelet’s technique is a viable option in the management of large defects. It is based on two principal steps: the formation of induction membrane and cancellous bone grafting. Defects as large as 25 cm can be successfully treated with this technique. The induction membrane is a viable tissue that plays a role in bone formation or incorporation. It has been demonstrated experimentally that the membrane contains elements that are important in bone formation and vascularization of cancellous bone placed inside the induction membrane. Research in still needed on this membrane in human subjects. Clinically the Masque let technique has been shown to be successful. The originator of the technique has the largest series to date plus the longest follow-up. Other clinicians have also shared their experience using the technique. Clinically more cases need to reported and guidelines established.