Clinical outcomes of induced membrane technique in treatment of traumatic segmental bone defects

Abstract

Objective To evaluate the clinical outcomes of induced membrane technique in the treat-ment of traumatic segmental bone defects. Methods From May 2011 to January 2016, we treated 10 pa-tients with traumatic segmental bone defect of the lower limb. They were 7 men and 3 women, with an average age of 41.6 years (from 18 to 61 years. The bone defects involved 8 tibias and 2 femurs; the mean length of the bone defects was 5.1 cm (from 2 to 15 cm). All the segmental bone defects were teated by induced membrane technique. At the first stage, the bone defects were filled with antibiotic-impregnated cement spacer after thor-ough debridement, the limb was fixated with external fixtor, and soft tissue repair was performed in 5 patients. On average all the patients received emergency treatment at the first stage 8.1 hours (from 4 to 13 hours) after trauma. At the second stage, after the cement was removed, the bone defects were filled with cancellous auto-grafts. An allograft was used when the autograft was not adequate enough. The external fixtor was exchanged by internal fixation in one patient according to his soft tissue condition and will; the exteranl fixation was retained in the other 9 patients. Results The average follow-up was 2.8 years (from 1.0 to 5.5 years). Bone healing was achieved in 9 patients after an average of 7.1 months (from 5 to 9 months), and nonunion happened in one patient whose bone graft had been not sufficient enough. Stress fracture occurred in one patient 7 months after bone healing, but it responded to conservative management. One patient reported numbness on the anterolateral thigh of the donor site. Pin tract infection occurred in 3 patients. Follow-ups revealed no limb length discrepancy or deep infection. Conclusion Induced membrane technique is a simple and reliable technique for the treatment of traumatic segmental bone defects. Key words: Bone defects; Induced membrane technique; Treatment outcome