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Modified Masquelet Technique and Primary Tibial Metaphyseal Shortening for the Management of Proximal Tibial-infected Non-union in a Patient with Alcohol-induced Neuropathy: A Case Study.

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العنوان: Modified Masquelet Technique and Primary Tibial Metaphyseal Shortening for the Management of Proximal Tibial-infected Non-union in a Patient with Alcohol-induced Neuropathy: A Case Study.
المؤلفون: Mahmoud AN; Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, Pennsylvania, United States of America; Department of Orthopaedic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Watson JT; Department of Orthopaedic Surgery, Saint Louis University, Saint Louis, Missouri, United States of America., Horwitz DS; Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, Pennsylvania, United States of America.
المصدر: Strategies in trauma and limb reconstruction [Strategies Trauma Limb Reconstr] 2023 Sep-Dec; Vol. 18 (3), pp. 181-185.
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Jaypee Brothers Medical Publishers Country of Publication: India NLM ID: 101299515 Publication Model: Print Cited Medium: Print ISSN: 1828-8936 (Print) Linking ISSN: 18288928 NLM ISO Abbreviation: Strategies Trauma Limb Reconstr Subsets: PubMed not MEDLINE
أسماء مطبوعة: Publication: 2019- : New Delhi, India : Jaypee Brothers Medical Publishers
Original Publication: Milan : Springer Milan, 2006-2018.
مستخلص: Aim: To highlight the role of the Masquelet technique as a limb salvage procedure for a neuropathic patient presenting with infected non-union of proximal tibia.
Background: The management of an infected non-union in neuropathic patients is most challenging; with various treatment options available, the prognosis is often guarded.
Case Description: A 37-year-old male with chronic polyneuropathy, also possessing a contralateral midfoot Charcot arthropathy secondary to a history of alcohol abuse, developed infection after a proximal tibial osteotomy for a preceding mal-non-union of a proximal tibia fracture. The management included hardware removal, excision of necrotic bone, interim insertion of antibiotic-loaded bone cement followed by an acute shortening and revision of the internal fixation utilising a second surgical incision. Successful bone union and eradication of infection was achieved and maintained after 13 months follow-up.
Conclusion: A successful outcome was achieved for an infected non-union of a long bone in a neuropathic patient using the Masquelet technique which was then followed with a second-stage removal of the spacer and shortening. By performing the revision ORIF surgery utilising a different skin incision in the setting of complicated previous surgical scars proved to be a viable technique towards reducing risk of recurrence of infection and a good outcome.
Clinical Significance: Utilisation of the Masquelet technique and limb shortening in a staged manner for the management of long bone infections in neuropathic patients has not been reported before and may be valuable in such demanding clinical situations.
How to Cite This Article: Mahmoud AN, Watson JT, Horwitz DS. Modified Masquelet Technique and Primary Tibial Metaphyseal Shortening for the Management of Proximal Tibial-infected Non-union in a Patient with Alcohol-induced Neuropathy: A Case Study. Strategies Trauma Limb Reconstr 2023;18(3):181-185.
Competing Interests: Source of support: Nil Conflict of interest: None Patient consent statement: The author(s) have obtained written informed consent from the patient for publication of the case report details and related images.
(Copyright © 2023; The Author(s).)
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فهرسة مساهمة: Keywords: Alcohol; Infected non-union; Masquelet; Neuropathy; Tibia
تواريخ الأحداث: Date Created: 20240226 Latest Revision: 20240227
رمز التحديث: 20240227
مُعرف محوري في PubMed: PMC10891357
DOI: 10.5005/jp-journals-10080-1604
PMID: 38404567
قاعدة البيانات: MEDLINE
الوصف
تدمد:1828-8936
DOI:10.5005/jp-journals-10080-1604