Management of Bone Failure in Fracture of the Distal Region of the Femur Using the Masquelet Technique with Fibula Graft Associated with Iliac-Crest Graft: Report of Two Cases

Pimenta, Frederico Silva; Prudêncio, Tardelli Lapaz da Silva; Ferreira, Gustavo Pacheco Martins; de Barros, Alessandro Cordoval; Caldas, Marco Túlio Lopes; Rodrigues, Heitor Maia

doi:10.1055/s-0040-1710336

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Case Report • Rev. bras. ortop. 57 (6) • Nov-Dec 2022 • https://doi.org/10.1055/s-0040-1710336 linkcopy

Management of Bone Failure in Fracture of the Distal Region of the Femur Using the Masquelet Technique with Fibula Graft Associated with Iliac-Crest Graft: Report of Two Cases^*

Authorship SCIMAGO INSTITUTIONS RANKINGS

Two cases of bone failure after fracture of the distal region of the femur treated with the Masquelet technique are presented. The first case involves acute bone loss, and the second, pseudarthrosis. The proper management of these lesions led to consolidation and a good functional result.

Keywords
bone graft; pseudarthrosis; femur fractures

Authorship

person Frederico Silva Pimenta

schoolOrthopedics and Traumatology Service, Hospital Maria Amélia Lins, Belo Horizonte, Minas Gerais, BrazilHospital Maria Amélia LinsBrazilBelo Horizonte, Minas Gerais, BrazilOrthopedics and Traumatology Service, Hospital Maria Amélia Lins, Belo Horizonte, Minas Gerais, Brazil

0000-0002-0921-0501

person Tardelli Lapaz da Silva Prudêncio

person Gustavo Pacheco Martins Ferreira

person Alessandro Cordoval de Barros

person Marco Túlio Lopes Caldas

person Heitor Maia Rodrigues

Address for correspondence Frederico Silva Pimenta, MsC, Rua do Campo 130, apt. 802, Vila da Serra, Nova Lima, Minas Gerais, 34006-062, Brasil,
fredericopimenta86@hotmail.com

Conflict of Interests

The authors have no conflict of interests to declare.

Work developed at the Orthopedics and Traumatology Service, Hospital Maria AméliaLins, Belo Horizonte, Minas Gerais, Brazil.

SCIMAGO INSTITUTIONS RANKINGS

Orthopedics and Traumatology Service, Hospital Maria Amélia Lins, Belo Horizonte, Minas Gerais, BrazilHospital Maria Amélia LinsBrazilBelo Horizonte, Minas Gerais, BrazilOrthopedics and Traumatology Service, Hospital Maria Amélia Lins, Belo Horizonte, Minas Gerais, Brazil

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Figures (5)

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Fig. 1 (A) Anteroposterior (AP) radiograph of the knee demonstrating bone failure. (B) Computed tomography (CT) coronal section demonstrating bone loss and a small joint fragment of the lateral femoral condyle and (C) a sagittal cut of an associated Hoffa fracture.

Thumbnail

Fig. 2 (A and B) Anteroposterior (AP) and profile radiographs demonstrating bone failure filled with orthopedic cement and fixation of joint fragments and medial blocked plate. (C) Vascularized membrane after cement removal – tip of the clamp. (D) Bone failure filled with fibula graft and iliac-crest graft.

Thumbnail

Fig. 3 (A and B) Anteroposterior (AP) and profile radiographs demonstrating bone consolidation. (C and D) Final range of motion.

Thumbnail

Fig. 4 (A and B) Anteroposterior (AP) radiographs and computed tomography (CT) scans demonstrating unfeasible bone segment and pseudarthrosis of the distal region of the femur. (C and D) Devitalized bone tissue removed and defect filled with orthopedic cement with antibiotics and fixation with lateral blocked plate (X-ray).

Thumbnail

Fig. 5 (A) Vascularized-fibula autologous graft (arrow – blood vessel ). (B and C) Postoperative radiograph demonstrating consolidation. (D) Range of motion.

imageFig. 1 (A) Anteroposterior (AP) radiograph of the knee demonstrating bone failure. (B) Computed tomography (CT) coronal section demonstrating bone loss and a small joint fragment of the lateral femoral condyle and (C) a sagittal cut of an associated Hoffa fracture. open_in_new

imageFig. 2 (A and B) Anteroposterior (AP) and profile radiographs demonstrating bone failure filled with orthopedic cement and fixation of joint fragments and medial blocked plate. (C) Vascularized membrane after cement removal – tip of the clamp. (D) Bone failure filled with fibula graft and iliac-crest graft. open_in_new

imageFig. 3 (A and B) Anteroposterior (AP) and profile radiographs demonstrating bone consolidation. (C and D) Final range of motion. open_in_new

imageFig. 4 (A and B) Anteroposterior (AP) radiographs and computed tomography (CT) scans demonstrating unfeasible bone segment and pseudarthrosis of the distal region of the femur. (C and D) Devitalized bone tissue removed and defect filled with orthopedic cement with antibiotics and fixation with lateral blocked plate (X-ray). open_in_new

imageFig. 5 (A) Vascularized-fibula autologous graft (arrow – blood vessel ). (B and C) Postoperative radiograph demonstrating consolidation. (D) Range of motion. open_in_new

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Management of Bone Failure in Fracture of the Distal Region of the Femur Using the Masquelet Technique with Fibula Graft Associated with Iliac-Crest Graft: Report of Two Cases*

Management of Bone Failure in Fracture of the Distal Region of the Femur Using the Masquelet Technique with Fibula Graft Associated with Iliac-Crest Graft: Report of Two Cases^*