Restoration of long bone defects of infected tibia with induced membrane technique / 中华创伤骨科杂志

ABSTRACT

Objective To evaluate the induced membrane technique (Masquelet technique) used for restoration of long bone defects of infected tibia.Methods This retrospective study evaluated 44 patients with long bone defect of infected tibia who had been treated at Department of Orthopedics,The Second Affiliated Hospital by the induced membrane technique between January 2004 and January 2017.They were 31 males and 13 females,aged from 18 to 71 years (mean,43.7 years).Of them,17 were complicated with diabetes,13 with primary hypertension,and 12 with more than two basic diseases.Their bone defects ranged from 6 to 17 cm (average,11 cm).Their postoperative fracture healing and complications were observed.Results This cohort received from 2 to 5 operations on average (average,3.7 operations).All the patents obtained bony union after 9 to 13 months (average,11.3 months).Their follow-ups ranged from 16 months to 11 years (average,3.1 years).Nineteen complications related to the surgery occurred in 15 cases.Skin healing problem after implantation of bone cement was found in 5 cases which called for operative intervention,infection relapsed in 8 patients after the first phase of cement implantation which necessitated further surgical debridement for successful management,local haematoma appeared after bone grafting in one case of 17 cm bone defect,implant failure occurred in one case,leg length discrepancy larger than 2 cm was observed in 3 cases,and a discharging sinus developed in one case 2 years after successful healing of a tibial defect.Conclusions The induced membrane technique appears to be a good alternative management for large tibial defects secondary to infection.The technique should be considered in the surgeon's armamentarium and patients conditions as it is effective and associated with a low rate of complications.