An anesthesiological complication related to bone cement use during reconstructive osteoplasty using the Masquelet technique in a pediatric patient: a case report.
1
DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY, LVIV, UKRAINE
Publication date: 2026-07-30
Corresponding author
Volodymyr Mishchuk
Department of anesthesiology and intensive care, Danylo Halytsky Lviv National Medical University, Chernihivska St., 7, 79010, Lviv, Ukraine
Department of anesthesiology and intensive care, Danylo Halytsky Lviv National Medical University, Chernihivska St., 7, 79010, Lviv, Ukraine
Wiadomości Lekarskie 2026;(7):1709-1714
KEYWORDS
TOPICS
ABSTRACT
Aim:
To present a rare case of bone cement implantation syndrome (BCIS) in a pediatric patient during reconstructive osteoplasty using the Masquelet technique and discuss its anesthesiological significance.
Material and methods:
This case report is based on clinical observation, perioperative anesthetic records, laboratory findings, and postoperative follow-up. A review of relevant literature was also performed to compare pediatric and adult cases of BCIS.
Case report:
A 16-year-old male (ASA II, BMI 31) underwent reconstructive osteoplasty with insertion of a polymethylmethacrylate (PMMA) spacer. Shortly after cement application, he developed sudden hypotension, tachycardia, and decreased end-tidal CO₂, consistent with Grade II BCIS. Supportive management with fluids, ketamine, and norepinephrine stabilized the patient. Postoperatively, he experienced recurrent hypotension, acute kidney injury, and elevated liver enzymes and creatine kinase. Intensive care treatment resulted in recovery, and he was discharged from the ICU on day five.
Summary:
Bone cement implantation syndrome, though exceptionally uncommon in pediatric patients, may develop during orthopedic procedures involving polymethylmethacrylate. Early recognition, continuous anesthetic vigilance, and timely multidisciplinary intervention are crucial to reduce morbidity and improve perioperative outcomes.
To present a rare case of bone cement implantation syndrome (BCIS) in a pediatric patient during reconstructive osteoplasty using the Masquelet technique and discuss its anesthesiological significance.
Material and methods:
This case report is based on clinical observation, perioperative anesthetic records, laboratory findings, and postoperative follow-up. A review of relevant literature was also performed to compare pediatric and adult cases of BCIS.
Case report:
A 16-year-old male (ASA II, BMI 31) underwent reconstructive osteoplasty with insertion of a polymethylmethacrylate (PMMA) spacer. Shortly after cement application, he developed sudden hypotension, tachycardia, and decreased end-tidal CO₂, consistent with Grade II BCIS. Supportive management with fluids, ketamine, and norepinephrine stabilized the patient. Postoperatively, he experienced recurrent hypotension, acute kidney injury, and elevated liver enzymes and creatine kinase. Intensive care treatment resulted in recovery, and he was discharged from the ICU on day five.
Summary:
Bone cement implantation syndrome, though exceptionally uncommon in pediatric patients, may develop during orthopedic procedures involving polymethylmethacrylate. Early recognition, continuous anesthetic vigilance, and timely multidisciplinary intervention are crucial to reduce morbidity and improve perioperative outcomes.
| eISSN: | 2719-342X |
| ISSN: | 0043-5147 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
