title: Reconstruction of Long Bone Infections Using the Induced Membrane Technique: Tips and Tricks.
abstract: The management of posttraumatic long bone osteomyelitis remains a challenging clinical problem. A systematic approach is necessary, beginning with eradication of the infected bone and soft tissue. There are a number of options for reconstruction of the remaining bone defect, including the induced membrane technique developed by Masquelet. We describe our technique for the 2-stage treatment of long bone osteomyelitis. The first stage involves a radical debridement, stabilization of the bone with either external fixation or an antibiotic-coated intramedullary nail, and placement of a polymethylmethacrylate spacer. The second stage includes excision of the spacer and placement of autologous bone graft. Various resection methods, fixation strategies, antibiotic additives, and types of bone grafts or substitutes can be used. The purpose of our technical article is to share our personal experience and describe several nuances that are critical for the success of this treatment strategy.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedics, Denver Health Medical Center, University of Colorado, School of Medicine, Denver, CO; †Department of Orthopaedic Surgery, University of Michigan Health System, Ann Arbor, MI; and ‡Service de chirurgie orthope[Combining Acute Accent]dique, traumatologique, ho[Combining Circumflex Accent]pital Saint-Antoine, Paris, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Mauffrey
authors.forename: Mark E
authors.initials: ME
authors.lastname: Hake
authors.forename: Vivek
authors.initials: V
authors.lastname: Chadayammuri
authors.forename: Alain-Charles
authors.initials: AC
authors.lastname: Masquelet
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001858:Bone Nails; D016025:Bone Transplantation / Q000379:methods*; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods*; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D010019:Osteomyelitis / Q000209:etiology / Q000628:therapy*; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D019904:Polymethyl Methacrylate