Application of the induced membrane technique for treatment of diaphyseal bone defect secondary to osteomyelitis of ulna: A modified approach

Abstract

Induced membrane technique has gained wide popularity since it was first described by Alain C Masquelet in the year 2000. Before the advent of this procedure, the vascularized bone free transfer and the Ilizarov bone transport method were the only two salvage methods which produced satisfactory results in cases of wide long bone diaphyseal defects. The classical Masquelet technique described, involves the use of cancellous bone graft in a biological membrane, which is induced after placing polymethylmethacrylate (PMMA) cement that allows the formation of new bone. We report a case of a 21-year-old girl who had chronic osteomyelitis of ulna resulting in a segmental bony defect of 8 cm treated by modified Masquelet technique. Instead of using only the cancellous graft, we used a combination of fibular strut graft with iliac cancellous graft to reduce the period of morbidity and increase the chances of union. Radiographs done at 3 month-follow-up showed good integration of the graft on either end of the fibula strut graft. Patient had an excellent functional and radiological outcome. The modified-induced membrane technique for the treatment of posttraumatic osteomyelitis of the ulna is a simple, reliable method, with good early results.