TREATMENT OF SEPTIC NONUNION OF LONG BONES: PRELIMINARY RESULTS OF A TWO-STAGE PROCEDURE

Purpose: Management of septic nonunion of long bones is a difficult challenge requiring a multidisciplinary approach. The purpose of this study was to report our results with a two-stage technique using a spacer (Masquelet technique).Material and methods: Between June 1997 and July 2001, eleven patients were treated for septic nonunion (n=7) or suspected septic nonunion (n= =4). There were seven men and four women: mean age 38 years (26–51). Nonunion involved the humerus (n=1), the femur (n=1), and the tibia (n=9). The same surgical technique was used in all cases: “carcinologic” debridement with gap filling using antibiotic cement and osteosynthesis when necessary, followed by a second procedure two months later to remove the spacer and insert an autologous bone graft when laboratory results had returned to normal.Results: Mean follow-up was three years (1–5). All patients achieved per primam bone healing within 4.5 months (3–6) despite a mean bone gap of 55 mm (15–100) after avivement. Intraoperative sa...