Induced membrane technique for the treatment of severe acute tibial bone loss: preliminary experience at medium-term follow-up

Int Orthop. 2019 Jan;43(1):209-215. doi: 10.1007/s00264-018-4164-8. Epub 2018 Oct 2.

Abstract

Purpose: Management of acute open tibial fractures with critical bone defect remains a challenge in trauma surgery. Few and heterogeneous cases have been reported about the treatment with the induced membrane technique.

Methods: We prospectively evaluated three patients treated with the induced membrane technique for acute Gustilo IIIB tibial fractures with critical bone defect. Success treatment was defined by bone union with patient pain free. Clinical and radiological evaluations were performed regularly until healing, then annually and with a minimum follow-up of five years.

Results: In all patients but one, a success was recorded, respectively, at four and six months. These two patients were pain free until the final follow-up, and no graft resorption or secondary complications related to the index surgery were observed. The third case was managed successfully with a bone transport technique.

Conclusion: The induced membrane technique is an alternative good option for the treatment of these severe lesions.

Keywords: Bone defect; Bone reconstruction; Induced membrane; Masquelet technique; Open fracture.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Bone Resorption / etiology
  • Bone Resorption / surgery*
  • Bone Transplantation / methods
  • Female
  • Follow-Up Studies
  • Fracture Fixation / methods*
  • Fracture Fixation, Internal / methods
  • Fractures, Open / complications
  • Fractures, Open / surgery*
  • Humans
  • Male
  • Middle Aged
  • Surgical Flaps / blood supply
  • Tibia / pathology
  • Tibia / surgery*
  • Tibial Fractures / complications
  • Tibial Fractures / surgery*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents