Masquelet Reconstruction Distal Femoral Segmental Defect After 3A Open Fracture

High-energy open fracturesOpen fractures of the distal femur often have segmental defects in the meta-diaphyseal region, with bone loss commonly measuring 6–10 cm or more in length. This is an ideal indication for reconstruction in a staged fashion using the induced membrane technique described by MasqueletMasquelet. The fracture is stabilized with a locked plate and a PMMA spacer is used to fill the defect for 6–12 weeks. A membrane that is biologically active will at that point envelope the spacer; in a planned second stage the spacer is carefully removed while preserving this membrane. The spacer is exchanged for bone graft, and the membrane closed to contain the graft. Large segmental femoral defects can be successfully reconstructed using this technique.