應用Masquelet技術修復骨缺損的研究進展_《中國修復重建外科雜志》

作者：

殷渠東 , 孫振中 , 顧三軍

無錫市第九人民醫院骨科（江蘇無錫，214062）;

關鍵詞：

骨缺損骨水泥骨移植 Masquelet技術

DOI：

10.7507/1002-1892.20130277

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目的綜述應用Masquelet技術修復骨缺損的研究進展。方法廣泛查閱近年來有關應用Masquelet技術修復骨缺損的文獻，對其進行綜合分析。結果Masquelet技術包括兩個階段手術，第一階段：先徹底清創，以骨水泥填充骨缺損區，待骨水泥周圍誘導形成誘導膜結構；第二階段：6～8周后取出骨水泥，在誘導膜內植入較豐富松質骨，通過誘導膜內松質骨較快成骨并皮質化來修復長段皮質骨缺損。實驗研究顯示，誘導膜上有小血管系統，還富含VEGF、TGF-β1、BMP-2和骨祖細胞等，具有誘導成骨屬性；在幾乎各部位、各種類型骨缺損臨床應用中，包括缺損長達25 cm患者，均取得滿意修復效果。與現有其他方法相比，Masquelet技術具有療效可靠、操作簡便、并發癥少、對受區要求低、易推廣等優點。結論Masquelet技術是修復骨缺損的有效方法之一，適應于各種類型骨缺損，尤其適合感染性和腫瘤性骨缺損。

引用本文： 殷渠東,孫振中,顧三軍. 應用Masquelet技術修復骨缺損的研究進展. 中國修復重建外科雜志, 2013, 27(10): 1273-1276. doi: 10.7507/1002-1892.20130277 復制

1.	Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet, 2000, 45(3): 346-353.
2.	Masquelet AC, Begue T. The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am, 2010, 41(1): 27-37.
3.	Giannoudis PV, Faour O, Goff T, et al. Masquelet technique for the treatment of bone defects: tips-tricks and future directions. Injury, 2011, 42(6): 591-598.
4.	Pelissier P, Masquelet AC, Bareille R, et al. Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res, 2004, 22(1): 73-79.
5.	Fitoussi F, Masquelet AC, Rigal S, et al. Inter-tibiofibular graft for traumatic segmental bone defect of the tibia. Orthop Traumatol Surg Res, 2012, 98(2): 214-219.
6.	Masquelet AC, Obert L. Induced membrane technique for bone defects in the hand and wrist. Chir Main, 2010, 29 Suppl 1: S221-224.
7.	Zwetyenga N, Catros S, Emparanza A, et al. Mandibular reconstruction using induced membranes with autologous cancellous bone graft and HA-betaTCP: animal model study and preliminary results in patients. Int J Oral Maxillofac Surg, 2009, 38(12): 1289-1297.
8.	Klaue K, Knothe U, Anton C, et al. Bone regeneration in long-bone defects: tissue compartmentalisation? In vivo study on bone defects in sheep. Injury, 2009, 40(Suppl 4): S95-102.
9.	Viateau V, Guillemin G, Calando Y, et al. Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects: an ovine model. Vet Surg, 2006, 35(5): 445-452.
10.	Pelissier P, Martin D, Baudet J, et al. Behaviour of cancellous bone graft placed in induced membranes. Br J Plast Surg, 2002, 55(7): 596-598.
11.	柳海曉, 徐華梓, 張宇, 等. 骨水泥表面粗糙度對誘導膜組織學特性的影響. 中國骨傷, 2012, 28(8): 662-666.
12.	Flamans B, Pauchot J, Petite H, et al. Use of the induced membrane technique for the treatment of bone defects in the hand or wrist, in emergency. Chir Main, 2010, 29(5): 307-314.
13.	Apard T, Bigorre N, Cronier P, et al. Two-stage reconstruction of post-traumatic segmental tibia bone loss with nailing. Orthop Traumatol Surg Res, 2010, 96(5): 549-553.
14.	Donegan DJ, Scolaro J, Matuszewski PE, et al. Staged bone grafting following placement of an antibiotic spacer block for the management of segmental long bone defects. Orthopedics, 2011, 34(11): e730-735.
15.	Karger C, Kishi T, Schneider L, et al. Treatment of posttraumatic bone defects by the induced membrane technique. Orthop Traumatol Surg Res, 2012, 98(1): 97-102.
16.	Rezzouk J, Leclerc J, Leger O, et al. Bone reconstruction with induced membrances and cancellous autograft: results in 18 cases of osteitis. J Bone Joint Surg (Br), 2005, 87(Suppl 2): 98.
17.	Powerski M, Maier B, Frank J, et al. Treatment of severe osteitis after elastic intramedullary nailing of a radial bone shaft fracture by using cancellous bone graft in Masquelet technique in a 13-year-old adolescent girl. J Pediatr Surg, 2009, 44(8): E17-19.
18.	Woon CY, Chong KW, Wong MK. Induced membrances—a staged technique of bone-grafting for segmental bone loss: a report of two case and literature review. J Bone Joint Surg (Am), 2010, 92(1): 196-201.
19.	Biau DJ, Pannier S, Masquelet AC, et al. Case report: reconstruction of a 16-cm diaphyseal defect after Ewing’s resection in a child. Clin Orthop Relat Res, 2009, 467(2): 572-577.
20.	Chotel F, Nguiabanda L, Braillon P, et al. Induced membrane technique for reconstruction after bone tumor resection in children: a preliminary study. Orthop Traumatol Surg Res, 2012, 98(3): 301-308.
21.	Villemagne T, Bonnard C, Accadbled F, et al. Intercalary segmental reconstruction of long bones after malignant bone tumor resection using primary methyl methacrylate cement spacer interposition and secondary bone grafting: the induced membrane technique. J Pediatr Orthop, 2011, 31(5): 570-576.
22.	Zappaterra T, Ghislandi X, Adam A, et al. Induced membrane technique for the reconstruction of bone defects in upper limb. A prospective single center study of nine cases. Chir Main, 2011, 30(4): 255-263.
23.	Uzel AP, Lemonne F, Casoli V. Tibial segmental bone defect reconstruction by Ilizarov type bone transport in an induced membrane. Orthop Traumatol Surg Res, 2010, 96(2): 194-198.
24.	O’Malley NT, Kates SL. Advances on the Masquelet technique using a cage and nail construct. Arch Orthop Trauma Surg, 2012, 132(2): 245-248.
25.	Stafford PR, Norris BL. Reamer-irrigator-aspirator bone graft and bi Masquelet technique for segmental bone defect nonunions: a review of 25 cases. Injury, 2010, 41(Suppl 2): S72-77.
26.	Huffman LK, Harris JG, Suk M. Using the bi-masquelet technique and reamer-irrigator-aspirator for post-traumatic foot reconstruction. Foot Ankle Int, 2009, 30(9): 895-899.
27.	De Biase P, Campanacci DA, Beltrami G, et al. Scaffolds combined with stem cells and growth factors in healing of pseudotumoral lesions of bone. Int J Immunopathol Pharmacol, 2011, 24(1 Suppl 2): 11-15.

1. Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet, 2000, 45(3): 346-353.
2. Masquelet AC, Begue T. The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am, 2010, 41(1): 27-37.
3. Giannoudis PV, Faour O, Goff T, et al. Masquelet technique for the treatment of bone defects: tips-tricks and future directions. Injury, 2011, 42(6): 591-598.
4. Pelissier P, Masquelet AC, Bareille R, et al. Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res, 2004, 22(1): 73-79.
5. Fitoussi F, Masquelet AC, Rigal S, et al. Inter-tibiofibular graft for traumatic segmental bone defect of the tibia. Orthop Traumatol Surg Res, 2012, 98(2): 214-219.
6. Masquelet AC, Obert L. Induced membrane technique for bone defects in the hand and wrist. Chir Main, 2010, 29 Suppl 1: S221-224.
7. Zwetyenga N, Catros S, Emparanza A, et al. Mandibular reconstruction using induced membranes with autologous cancellous bone graft and HA-betaTCP: animal model study and preliminary results in patients. Int J Oral Maxillofac Surg, 2009, 38(12): 1289-1297.
8. Klaue K, Knothe U, Anton C, et al. Bone regeneration in long-bone defects: tissue compartmentalisation? In vivo study on bone defects in sheep. Injury, 2009, 40(Suppl 4): S95-102.
9. Viateau V, Guillemin G, Calando Y, et al. Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects: an ovine model. Vet Surg, 2006, 35(5): 445-452.
10. Pelissier P, Martin D, Baudet J, et al. Behaviour of cancellous bone graft placed in induced membranes. Br J Plast Surg, 2002, 55(7): 596-598.
11. 柳海曉, 徐華梓, 張宇, 等. 骨水泥表面粗糙度對誘導膜組織學特性的影響. 中國骨傷, 2012, 28(8): 662-666.
12. Flamans B, Pauchot J, Petite H, et al. Use of the induced membrane technique for the treatment of bone defects in the hand or wrist, in emergency. Chir Main, 2010, 29(5): 307-314.
13. Apard T, Bigorre N, Cronier P, et al. Two-stage reconstruction of post-traumatic segmental tibia bone loss with nailing. Orthop Traumatol Surg Res, 2010, 96(5): 549-553.
14. Donegan DJ, Scolaro J, Matuszewski PE, et al. Staged bone grafting following placement of an antibiotic spacer block for the management of segmental long bone defects. Orthopedics, 2011, 34(11): e730-735.
15. Karger C, Kishi T, Schneider L, et al. Treatment of posttraumatic bone defects by the induced membrane technique. Orthop Traumatol Surg Res, 2012, 98(1): 97-102.
16. Rezzouk J, Leclerc J, Leger O, et al. Bone reconstruction with induced membrances and cancellous autograft: results in 18 cases of osteitis. J Bone Joint Surg (Br), 2005, 87(Suppl 2): 98.
17. Powerski M, Maier B, Frank J, et al. Treatment of severe osteitis after elastic intramedullary nailing of a radial bone shaft fracture by using cancellous bone graft in Masquelet technique in a 13-year-old adolescent girl. J Pediatr Surg, 2009, 44(8): E17-19.
18. Woon CY, Chong KW, Wong MK. Induced membrances—a staged technique of bone-grafting for segmental bone loss: a report of two case and literature review. J Bone Joint Surg (Am), 2010, 92(1): 196-201.
19. Biau DJ, Pannier S, Masquelet AC, et al. Case report: reconstruction of a 16-cm diaphyseal defect after Ewing’s resection in a child. Clin Orthop Relat Res, 2009, 467(2): 572-577.
20. Chotel F, Nguiabanda L, Braillon P, et al. Induced membrane technique for reconstruction after bone tumor resection in children: a preliminary study. Orthop Traumatol Surg Res, 2012, 98(3): 301-308.
21. Villemagne T, Bonnard C, Accadbled F, et al. Intercalary segmental reconstruction of long bones after malignant bone tumor resection using primary methyl methacrylate cement spacer interposition and secondary bone grafting: the induced membrane technique. J Pediatr Orthop, 2011, 31(5): 570-576.
22. Zappaterra T, Ghislandi X, Adam A, et al. Induced membrane technique for the reconstruction of bone defects in upper limb. A prospective single center study of nine cases. Chir Main, 2011, 30(4): 255-263.
23. Uzel AP, Lemonne F, Casoli V. Tibial segmental bone defect reconstruction by Ilizarov type bone transport in an induced membrane. Orthop Traumatol Surg Res, 2010, 96(2): 194-198.
24. O’Malley NT, Kates SL. Advances on the Masquelet technique using a cage and nail construct. Arch Orthop Trauma Surg, 2012, 132(2): 245-248.
25. Stafford PR, Norris BL. Reamer-irrigator-aspirator bone graft and bi Masquelet technique for segmental bone defect nonunions: a review of 25 cases. Injury, 2010, 41(Suppl 2): S72-77.
26. Huffman LK, Harris JG, Suk M. Using the bi-masquelet technique and reamer-irrigator-aspirator for post-traumatic foot reconstruction. Foot Ankle Int, 2009, 30(9): 895-899.
27. De Biase P, Campanacci DA, Beltrami G, et al. Scaffolds combined with stem cells and growth factors in healing of pseudotumoral lesions of bone. Int J Immunopathol Pharmacol, 2011, 24(1 Suppl 2): 11-15.

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應用Masquelet技術修復骨缺損的研究進展

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