大腿骨開放骨折後の骨欠損に対してMasquelet法と血管柄付き腓骨移植を併用した 1 例

抄録

The Masquelet technique is gaining popularity in reconstructive procedures for large bone defects. However, surgery timing and required quantity of graft bone remain topics of discussion. In patients who sustain traumatic injuries, reconstructive surgery using a free vascularized fibula graft (FVFG) should be performed as soon as possible to avoid vasospasm and adhesion complications. In contrast, the second stage of the Masquelet procedure is usually performed approximately 6 weeks after the first stage.
We report the case of a patient who simultaneously underwent the Masquelet technique and FVFG reconstructive surgery for a large bone defect in the femur. A 54-year-old man injured his left thigh in a motorcycle accident. X-ray examination revealed an open fracture with a 17-cm length bone defect in his left femur. The bone defect was considered too long to treat by either the Masquelet technique or FVFG alone. He underwent surgery that combined the Masquelet and FVFG techniques. He was able to walk 7 months after the surgery. We consider the combination of the Masquelet technique and FVFG reconstruction to be a useful method for complete recovery, especially for injures resulting in severe fracture with a large bone defect.