Reconstruction of traumatic bone loss using the induced membrane technique: preliminary results about 11 cases.

INTRODUCTION: The use of Masquelet technique is a serious option to consider for biologic reconstruction of severe bone loss. Here is exposed a continuous and prospective study on bone loss management using that technique. The aims of this study were to assess epidemiology of bone loss due either to trauma or to non-unions and to give preliminary results.

PATIENTS AND METHODS: It was a prospective study from April 2015 to december 2016 involving patients treated using the induced membrane technique for a diaphyseal bone defect due either to trauma or non-unions. AO plates or Orthofix external fixators were used for osteosynthesis. Bone healing was radiologically assessed and any complications were listed.

RESULTS: During the study period, 11 patients were treated using the induced membrane technique. There were 8 males and 3 females. Their mean age was 40.45 years (21-59). The skeletal segments concerned were 2 humerus, 6 femurs and 3 tibias with a mean bone defect length of 4,45 cm (2.5-8). The delay between reconstruction and trauma was 8 months (20 days - 3 years). After a mean follow-up of 6.54 months (3-11) six patients presented a good radiological healing (4 femurs, 2 humerus) whereas in four patients, autograft osteointegration was still ongoing (2 femurs, 2 tibias). A tibia secondary infection was observed in a patient with the graft partial resorption. In another patient, an initial gangrene lead to a leg amputation.

CONCLUSION: The induced membrane technique is an excellent option for bone defect reconstruction compared to other usual bone graft techniques. It helped us to manage large bone loss in various skeletal segments.