Induced membrane technique for treating tibial defects gives mixed results

Bone Joint J. 2017 May;99-B(5):680-685. doi: 10.1302/0301-620X.99B5.BJJ-2016-0694.R2.

Abstract

Aims: This study describes the use of the Masquelet technique to treat segmental tibial bone loss in 12 patients.

Patients and methods: This retrospective case series reviewed 12 patients treated between 2010 and 2015 to determine their clinical outcome. Patients were mostly male with a mean age of 36 years (16 to 62). The outcomes recorded included union, infection and amputation. The mean follow-up was 675 days (403 to 952).

Results: The mean tibial defect measured 5.8 cm (2 to 15) in length. Of the 12 patients, 11 had an open fracture. Eight underwent fixation with an intramedullary nail, three with plates and one with a Taylor Spatial Frame. The mean interval between stages was 57 days (35 to 89). Bony union was achieved in only five patients. Five patients experienced infective complications during treatment, with two requiring amputation because of severe infection.

Conclusion: The Masquelet technique was relatively ineffective in achieving union in this series, and was associated with a high rate of infection. Cite this article: Bone Joint J 2017;99-B:680-5.

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

MeSH terms

  • Adolescent
  • Adult
  • Amputation
  • Bone Plates
  • Bone Transplantation / methods
  • Debridement / methods
  • Female
  • Fracture Fixation, Internal / methods*
  • Fracture Fixation, Intramedullary / methods
  • Fracture Healing
  • Fractures, Open / diagnostic imaging
  • Fractures, Open / pathology
  • Fractures, Open / surgery
  • Humans
  • Male
  • Middle Aged
  • Osteomyelitis / surgery
  • Radiography
  • Retrospective Studies
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / pathology
  • Tibial Fractures / surgery*
  • Treatment Outcome
  • Young Adult