A case report of extensive segmental defect of the humerus due to thermal necrosis treated with Masquelet technique

Abstract

Thermal necrosis due to over-reaming or blunt reamer may have devastating consequences. We present one such case of humerus shaft fracture referred to us at two and half months after primary surgery with active signs of infection and sequestrated segment of the humerus. The challenges were not only to achieve union, control of infection, but also the 10 cm bone gap created after removal of sequestrated part of humerus and preservation of reasonable function of adjacent joints. Emergency drainage of thick purulent material was done on day one because the patient was in excessive pain, the abscess was likely to burst and she was unfit for major surgery due to her toxic clinical state abnormal blood parameters. We had managed this case successfully using Masquelet technique.Masquelet technique is an excellent option for bone gap reconstruction compared to other techniques. It helped us to achieve good functional outcomes and to manage large bone loss in infected humeral non-union.

Keywords

• Masquelet technique
• Induced membrane technique
• Segmental bone defect
• Thermal necrosis reaming
• Infected humerus fracture