title: Treatment of posttraumatic bone defects by the induced membrane technique.
abstract: BACKGROUND
  Among bone reconstruction techniques, the induced membrane technique, proposed in 1986 by Masquelet, has rarely been studied or evaluated in the surgical literature until recently. The 2010 French Society of Orthopaedic Surgery and Traumatology (SoFCOT) Annual Convention symposium was the occasion to evaluate a large cases series having used this technique.
  
  
  METHODS
  This retrospective study included 84 posttraumatic diaphyseal long bone reconstructions using the induced membrane technique (1988-2009). The series included 79 men and five women (mean age 32-year-old). In 89% of cases, the initial trauma was an open fracture. The leg was involved in 70% of cases. The mean delay between the accident and treatment of bone defects (BD) was 8 months. In 50% of the cases, infection was present. Bone defects were larger than 5cm in 57% of the cases.
  
  
  RESULTS
  Union was obtained in 90% of cases, a mean 14.4 months after the first stage of the reconstruction. A mean 6.11 interventions were necessary to obtain union. Malalignment was present in 17% of cases. Delayed interventions to correct deformities mostly of the foot were necessary in 16% of the cases. Eight failures (10%) involved severe leg traumas associating extensive bone defects, soft tissue lesions and infection and required amputation in six cases.
  
  
  CONCLUSIONS
  This series emphasizes the severity of open fractures of the leg, especially those with primary or secondary infection. The induced membrane technique has been shown to be effective in treating bone defects, regardless of their magnitude. In a two-step procedure, this simple but demanding technique, which may be more complicated when repair of soft tissue is necessary, provides successful treatment in case of initial infection and fulfills the goal of controlling infection before bone reconstruction. Moreover, the induced membrane technique can be integrated in hybrid reconstruction procedures.
  
  
  METHODS
  Level IV. Retrospective study.
authors.affiliation: Department of Pediatric Surgery, Hautepierre Teaching Hospital Center, Strasbourg, France.
authors.forename: C
authors.initials: C
authors.lastname: Karger
authors.forename: T
authors.initials: T
authors.lastname: Kishi
authors.forename: L
authors.initials: L
authors.lastname: Schneider
authors.forename: F
authors.initials: F
authors.lastname: Fitoussi
authors.forename: A-C
authors.initials: AC
authors.lastname: Masquelet
mesh_terms: D000328:Adult; D001843:Bone Cements; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013977:Tibia / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements