Traitement des pertes de substance osseuse chez l’enfant par la technique de masquelet (A propos de 06 cas)

The reconstruction of bone loss and non-binding in the long bones is a challenge for the orthopedic surgeon. The methods are many, but currently there is little consensus on how best to proceed. The technique developed by Masquelet involves the use of two operating times. The principle is to fill the bone defect with an inert material (cement), in order to create a membrane of foreign body around thereof. The latter defines a chamber that, upon removal of the cement, is capable of receiving a massive cancellous bone graft. Induced membrane plays a role in both mechanical: a real implantation chamber protecting the graft, and biological: the secretion of growth factors promoting osteogenesis and angiogenesis. Use of the technique of Masquelet improves the rates of bone healing; it is a real revolution and an alternative to other bone reconstruction techniques. Our work is a retrospective study of a series of 06 patients (4 boys and 2 girls) treated in the service of pediatric traumatology-orthopedic of university hospital Hassan II of Fez between 2011 and 2013, for a loss of segmental bone by introduced membrane technique. The bone loss was infectious for 3 patients, post traumatic for 1 patient, more a case of benign tumor lesion (aneurysmal cyst) and one case of congenital pseudarthrosis. The average age was 8.5 years (with a range of 14 months to 15 years) at the first time of reconstruction The average time to union was 6 months. With a mean of 20 months. The technique was successful with satisfactory results in 4 patients. Among them, three had a limb length inequality where elongation. However, two patients experienced a failure of the technique, it is a case of nonunion and resorption of the bone graft