Prise en Charge des Pertes de Substances Osseuses du Membre Inférieur par la Technique de Masquelet: Management of Lower Limb Bone Loss Using the Masquelet Technique

Abstract

Introduction: The management of bone loss (BL) is a therapeutic challenge for orthopaedic surgeons. The aim of this study was to review the treatment of BL using the Masquelet technique in a university hospital in sub-Saharan Africa. Patients and methods: we conducted a retrospective descriptive and secondary analytical study over a 5-year period in the orthopedic-traumatology department of the CHU Yalgado-Ouédraogo. Bone loss dimensions were measured to scale on radiographic films and distributed according to the SOFCOT classification. Results: We included 109 patients with a mean age of 33.73 ± 11.97 years, ranging from 16 to 69 years, and a sex ratio of 7.5. The socio-professional status most concerned was farmers (n=38; 34.86%). Road traffic accidents accounted for 92.16% of the circumstances in which OSIs occurred. The preferred sites of injury were the tibia and femur. Soft tissue injuries associated with OSI were predominantly musculocutaneous. SOFCOT types III (n=25; 49.02%) and IV (n=22; 43.14%) were the most frequent. All our patients were managed with cement containing antibiotics. Our patients (n=34; 66.7%) underwent 4 procedures. The main complications were infection (n=49; 96.1%) and bone exposure (n=20; 39.2%). Our study found factors associated with treatment failure, notably low socio-economic status and BL greater than 10 cm. Post-treatment mobility was assessed satisfactorily using the Parker score. Conclusion : This study showed that road traffic accidents are the main cause of BLs, which pose a therapeutic management problem due to the soft tissue lesions and high frequency of infection often associated with them. The key to exponentially reducing the failure rate lies in the right choice of therapeutic indication, proper application of the technique and monitoring.