Abstract
Background:
Segmental defects of long bones are notoriously demanding and difficult to treat. We evaluate nine cases where the Masquelet induced membrane technique to substitute bone loss has been used. We discuss the method compared to other types of bone reconstruction and share our tips and tricks to reduce treatment time and improve patient comfort.
Method:
Eight patients (nine injuries) operated between 2011 and 2014 were included. Four were infected. Outcome was time-to weight-bearing, consolidation, complications, bone grafting.
Results:
All patients were weight bearing fully after 270 days. Mean time to weight bearing was 225 days. Time to full weight bearing was shorter in patients where nails were used to stabilize the construct: median 115 (range 0–268) compared to plates: median 244 (range 219–271). All but two cases went on to full consolidation. Three cases needed grafting, one was misaligned. There were no amputations, no persistent infections, and no implant failures.
Discussion:
The induced membrane technique is a relevant alternative to traditional bone substitution in select cases, yet somewhat unpredictable in its course and prolonged immobilisation is often required.
Conclusion:
Nailing seems to improve the outcome by reducing treatment time and volume of bone graft needed and should be considered when feasible.
