Results of the Induced Membrane Technique in the Management of Traumatic Bone Loss in the Lower Limb: A Cohort Study

J Orthop Trauma. 2019 Mar;33(3):131-136. doi: 10.1097/BOT.0000000000001384.

Abstract

Objective: To present our technique and early results using the Masquelet technique.

Design: Retrospective cohort study.

Patients/participants: Thirteen patients with 14 open fractures of the femur and tibia were included between November 2013 and December 2014.

Intervention: A Masquelet technique was used to manage the open fractures.

Main outcome measure: Infection and union rate.

Results: The mean follow-up was 17 months. The mean bone defect was 56.6 mm. Eight fractures (57.1%) progressed to union at an average of 42.1 weeks. Infection developed in 3 fractures (21.4%). Overall, the induced membrane technique was abandoned in 5 (35.7%) cases.

Conclusions: The induced membrane technique showed a substantial rate of failure in the acute trauma setting in the lower limb. In the absence of sound published evidence, the authors now use the technique in selected cases only.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

MeSH terms

  • Absorbable Implants
  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Biocompatible Materials / administration & dosage
  • Bone Substitutes / administration & dosage*
  • Bone Substitutes / adverse effects
  • Bone Transplantation / methods*
  • Calcium Sulfate / administration & dosage
  • Debridement
  • Drug Implants / administration & dosage
  • Female
  • Femoral Fractures / complications
  • Femoral Fractures / physiopathology
  • Femoral Fractures / surgery*
  • Fracture Fixation, Internal / methods*
  • Fracture Healing
  • Fractures, Open / complications
  • Fractures, Open / physiopathology
  • Fractures, Open / surgery*
  • Humans
  • Lower Extremity / injuries
  • Lower Extremity / physiopathology
  • Lower Extremity / surgery
  • Male
  • Middle Aged
  • Polymethyl Methacrylate / administration & dosage
  • Polymethyl Methacrylate / adverse effects
  • Prosthesis Implantation / adverse effects
  • Prosthesis Implantation / methods
  • Retrospective Studies
  • Tibial Fractures / complications
  • Tibial Fractures / physiopathology
  • Tibial Fractures / surgery*
  • Wounds and Injuries / etiology
  • Wounds and Injuries / surgery
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Biocompatible Materials
  • Bone Substitutes
  • Drug Implants
  • Polymethyl Methacrylate
  • Calcium Sulfate