masquelet technique for midfoot reconstruction following osteomyelitis in charcot diabetic...

10
Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal JBJS Case Connect Volume 5(2):e28 April 8, 2015 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Upload: leslie-phelps

Post on 19-Dec-2015

232 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy

by May Fong Mak, Richard Stern, and Mathieu Assal

JBJS Case ConnectVolume 5(2):e28

April 8, 2015

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

Mal perforans ulcer with a rocker-bottom deformity in a Charcot foot (left).

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

Postoperative anteroposterior radiograph showing a well-aligned medial column and a cement spacer occupying the midfoot defect.

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

Postoperative lateral radiograph showing restoration of the height of the medial longitudinal arch.

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

The cement block that had been implanted six weeks earlier for membrane induction (left) was removed as atraumatically as possible to reveal the membrane chamber (right).

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

Immediate postoperative anteroposterior radiograph showing bone graft filling the midfoot defect.

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

Immediate postoperative lateral radiograph showing that a plantigrade foot had been achieved through the skeletal reconstruction.

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

Anteroposterior radiograph at twenty-five months postoperatively showing the graft assuming a cortical appearance.

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

Lateral radiograph at twenty-five months postoperatively demonstrating consolidation at the midfoot.

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Masquelet Technique for Midfoot Reconstruction Following Osteomyelitis in Charcot Diabetic Neuropathy by May Fong Mak, Richard Stern, and Mathieu Assal

A well-aligned foot without ulceration at twenty-five months postoperatively.

May Fong Mak et al. JBJS Case Connect 2015;5:e28

©2015 by The Journal of Bone and Joint Surgery, Inc.