A case report of extensive segmental defect of the humerus treated with Masquelet technique

Case report: Plate-assisted bone transport with uniplanar external fixator in large bone defects of the humerus

INTRODUCTION

We present a case series of two patients who underwent plate-assisted bone transport (PABT) with a uniplanar external fixator for the treatment of large bone defects of the humerus. The efficacy and outcomes were evaluated.

CASE PRESENTATION

A retrospective review of patients treated with PABT for humeral defects over a 2-year period was performed. Proper gap healing occurred within 3 months, and a long course of physiotherapy was involved in obtaining satisfactory outcomes.

DISCUSSION

Our results demonstrate that PABT might be a potentially effective alternative for large humeral defects, allowing controlled bone lengthening and healing without disrupting vascularity and providing stability for early motion.

CONCLUSION

PABT appears to be a viable option for the management of large humeral defects with good functional outcomes and a manageable complication profile.

Management of segmental bone defects of the upper limb: a scoping review with data synthesis to inform decision making

PURPOSE

Injuries to the long bones of the upper limb resulting in bone defects are rare but potentially devastating. Literature on the management of these injuries is limited to case reports and small case series. The aim of this study was to collate the most recent published work on the management of upper limb bone defects to assist with evidence based management when confronted with these cases.

METHODS

Following a preliminary search that confirmed the paucity of literature and lack of comparative trials, a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was conducted. A literature search of major electronic databases was conducted to identify journal articles relating to the management of upper limb long bone defects published between 2010 and 2020.

RESULTS

A total of 46 publications reporting on the management of 341 patients were reviewed. Structural autograft, bone transport, one-bone forearm and the induced membrane technique were employed in an almost equal number of cases. The implemented strategies showed similar outcomes but different indications and complication profiles were observed.

CONCLUSION

Contemporary techniques for the management of post-traumatic upper limb bone defects all produce good results. Specific advantages, disadvantages and complications for each modality should be considered when deciding on which management strategy to employ for each specific patient, anatomical location, and defect size.