title: Reconstruction of septic diaphyseal bone defects with the induced membrane technique.
abstract: Septic segmental bone voids of the diaphysis are difficult to manage. The induced membrane technique by Masquelet has been successfully used to reconstruct segmental defects more than 20 cm. Our article describes a series of 13 cases with extensive posttraumatic bone loss of the metatarsal, tibial, femoral and radial bones after septic injuries followed by multiple surgical interventions. Antibiotic-impregnated polymethyl methacrylate (PMMA) cement spacers were implanted after successful eradication of bacterial infections of soft tissue and bones. After a mean of 9.8 weeks, body-induced membranes were established and the cements spacers removed. To fill up the bone void, cancellous bone autografts were implanted into the membranes. The follow-up examination after 24 months revealed bony union in all cases and favorable functional results. The induced membrane technique has shown to be effective in treating bone defects of upper and lower extremity bone defects.
authors.affiliation: Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany.
authors.forename: Armin O
authors.initials: AO
authors.lastname: Scholz
authors.affiliation: Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany. Electronic address: sebastian.gehrmann@med.uni-duesseldorf.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Gehrmann
authors.affiliation: Berufsgenossenschaftliche Unfallklinik Duisburg, Department of Septic Surgery, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Glombitza
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kaufmann
authors.affiliation: Department of Neurosurgery, Heinrich-Heine Universität, Düsseldorf, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Bostelmann
authors.affiliation: Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Flohe
authors.affiliation: Department of Trauma and Hand Surgery, Heinrich-Heine Universität, Düsseldorf, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Windolf
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001843:Bone Cements; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000379:methods; D018483:Diaphyses / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D005858:Germany; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019904:Polymethyl Methacrylate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D008567:Membranes, Artificial; D019904:Polymethyl Methacrylate
keywords: Masquelet technique; bone defects; induced membrane technique; septic diaphyseal defects