Reconstruction of Long Bone Infections Using the Induced Membrane Technique: Tips and Tricks

Abstract The management of post-traumatic 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 two-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 (IMN) and placement of a polymethylmethacrylate (PMMA) 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 utilized. The purpose of our technical paper is to share our personal experience and describe several nuances that are critical for the success of this treatment strategy. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.