Treatment of distal tibia periarticular bone loss using the Masquelet technique with RIA bone graft

Published:December 03, 2018DOI:


      We report on the management of a patient who following a road traffic accident sustained a grade IIIB open fracture of the distal tibia with acute bone loss of the talus and distal tibia.
      The patient was managed with acute bone resection, and the two-stage Masquelet technique.
      He underwent stabilization with a hind-foot nail, application of RIA auto-graft and arthrodesis of the affected joint with a satisfactory functional outcome.
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        • Claude Sagi H.
        • Young M.L.
        • Gerstenfeld L.
        • Einhorn T.A.
        • Tornetta P.
        Qualitative and quantitative differences between bone graft obtained from the medullary canal (with a Reamer/Irrigator/Aspirator) and the iliac crest of the same patient.
        J Bone Joint Surg Am. 2012; 94: 2128-2135
        • Giannoudis P.V.
        • Calori G.M.
        Bone reconstruction using RIA graft: biological considerations and clinical resuls.
        Arch Ortop Reumatol. 2013; 124 (1–3 > 20–21): 20-21
        • Belthur M.V.
        • Conway J.D.
        • Jindal G.
        • Ranade A.
        • Herzenberg J.E.
        Bone graft harvest using a new intramedullary system.
        Clin Orthop Relat Res. 2008; 466: 2973-2980
        • Arealisa G.
        • Nikolaou V.S.
        Bone printing: new frontiers in the treatment of bone defects.
        Injury. 2015; 46: S20-2
        • Campanacci D.A.
        • Puccini S.
        • Caff G.
        • Beltrami G.
        • Piccioli A.
        • Innocenti M.
        • et al.
        Vascularised fibular grafts as a salvage procedure in failed intercalary reconstructions after bone tumour resection of the femur.
        Injury. 2014; 45: 399-404
        • Thaller P.H.
        • Fürmetz J.
        • Wolf F.
        • Eilers T.
        • Mutschler W.
        Limb lengthening with fully implantable magnetically actuated mechanical nails (PHENIX®)-preliminary results).
        Injury. 2014; 45 (Epub 2013 Oct 28): S60-S65
        • Kim P.H.
        • Leopold S.S.
        Gustilo-Anderson classification.
        Clin Orthop Relat Res. 2012; 470: 3270-3274
        • Togawa S.
        • Yamami N.
        • Nakayama H.
        • Mano Y.
        • Ikegami K.
        • Ozeki S.
        The validity of the mangled extremity severity score in the assessment of upper limb injuries.
        J Bone Joint Surg Br. 2005; 87: 1516-1519
        • D’Arpa S.
        • Toia F.
        • Pirrello R.
        • Moschella F.
        • Cordova A.
        Propeller flaps: a review of indications, technique, and results.
        Biomed Res Int. 2014; 2014986829
      1. Stewart S, Bryant SJ, Ahn J, Hankenson KD. Translational regenerative medicine. pp. 313–333:

        • Masquelet A.C.
        • Begue T.
        The concept of induced membrane for reconstruction of long bone defects.
        J Orthop Clin N Am. 2010; 41: 27-37
        • Masquele A.C.
        The reconstruction of wide diaphysed bone defect by foreign body induced membrane and bone graft.
        Les e-mémoires de l’Académie Nationale de Chirurgie. 2008; 7: 34-38
        • Karger C.
        • Kishi T.
        • Schneider L.
        • Fitoussi F.
        • Masquelet A.-C.
        Treatment of posttraumatic bone defects by the induced membrane technique.
        Orthop Traumatol Surg Res. 2012; 98: 97-102
        • Masquelet A.C.
        • Fitoussi F.
        • Begue T.
        • Muller G.P.
        Reconstruction of the long bones by the induced membrane and spongy autograft.
        Ann Chir Plast Esthétique. 2000; 45: 346-353
        • Azi M.L.
        • Teixeira A.A.A.
        • Cotias R.B.
        • Joeris A.
        • Kfuri Jr., M.
        Membrane induced osteogenesis in the management of posttraumatic bone defects.
        J Orthop Trauma. 2016; 30: 545-550
        • Pelissier P.H.
        • Masquelet A.C.
        • Bareille R.
        • Mathoulin Pelissier S.
        • Amedee J.
        Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration.
        J Orthop Res. 2004; 22: 73-79
        • Mauffrey C.
        • Barlow B.T.
        • Smith W.
        Management of segmental bone defects.
        J Am Acad Orthop Surg. 2015; 23: 143-153