Induced membrane technique for treatment of post-traumatic tibial osteomyelitis

Abstract

Purpose To investigate the clinical outcome of induced membrane technique for treatment of post-traumatic tibial osteomyelitis. Methods A retrospective analysis was made on 17 cases of post-traumatic tibial osteomyelitis admitted from August 2011 to October 2012. There were 13 males and 4 females aged 19-67 years (mean, 40.9 years). Mean length of bone defect was 6.7 cm (range, 2.0-18.5 cm). Surgical treatments were performed including phase Ⅰ surgical debridement and antibiotics-loaded bone cement impregnation to induce a membrane and phase Ⅱ bone defect reconstruction by intramembranous bone grafting. Clinical effect of the treatment was evaluated. Results Bone healing was detected at the 27-month follow-up (range, 24-32 months). Radiographic healing was obtained 4-6 months after operation. Two cases of recurrent infection were noted after phase Ⅰ surgery and had another debridement. External fixator proximal pin track infection occurred in one case and infection was controlled by hardware removal and dressing change. There was one case of metal rejection, two function disorders, one clubfoot, and one ankle stiffness. Conclusion Induced membrane technique is effective in the treatment of post-traumatic tibial osteomyelitis, especially in lone bone defect reconstruction, but limb functional complications are worth consideration during treatment. Key words: Osteomyelitis; Tibial fractures; Induced membrane technique