Preliminary Results of the "Capasquelet" Technique for Managing Femoral Bone Defects-Combining a Masquelet Induced Membrane and Capanna Vascularized Fibula with an Allograft.
Alexis CombalFrançois ThuauAlban Fouasson-ChaillouxPierre-Paul ArrigoniMarc Baud'huinFranck DuteilleVincent CrennPublished in: Journal of personalized medicine (2021)
We describe the preliminary results of a novel two-stage reconstruction technique for extended femoral bone defects using an allograft in accordance with the Capanna technique with an embedded vascularized fibula graft in an induced membrane according to the Masquelet technique. We performed what we refer to as "Capasquelet" surgery in femoral diaphyseal bone loss of at least 10 cm. Four patients were operated on using this technique: two tumors and two traumatic bone defects in a septic context with a minimum follow up of one year. Consolidation on both sides, when achieved, occurred at 5.5 months (4-7), with full weight-bearing at 11 weeks (8-12). The functional scores were satisfactory with an EQ5D of 63.3 (45-75). The time to bone union and early weight-bearing with this combined technique are promising compared to the literature. The osteoinductive role of the induced membrane could play a positive role in the evolution of the graft. Longer follow up and a larger cohort are needed to better assess the implications. Nonetheless, this two-stage technique appears to have ample promise, especially in a septic context or in adjuvant radiotherapy in an oncological context.
Keyphrases
- bone loss
- bone mineral density
- high glucose
- diabetic rats
- soft tissue
- early stage
- drug induced
- systematic review
- acute kidney injury
- end stage renal disease
- weight loss
- newly diagnosed
- spinal cord injury
- postmenopausal women
- radiation therapy
- endothelial cells
- ejection fraction
- squamous cell carcinoma
- radiation induced
- coronary artery disease
- kidney transplantation
- machine learning
- coronary artery bypass
- body weight
- locally advanced
- atrial fibrillation