Membrane Induced Osteogenesis in the Management of Posttraumatic Bone Defects.

Abstract To evaluate the union rate of post-traumatic bone defects treated with the induced membrane technique. Single center retrospective case series. Level I trauma center. Thirty-three patients who sustained 34 post-traumatic bone defects (19 tibia, 15 femur). Staged management using the induced membrane technique described by Masquelet. Following extensive debridement at the fracture site, a polymethylmethacrylate (PMMA) spacer was inserted into the resulting void. After soft tissue recovery, the spacer was removed, and the void, now enveloped by an induced membrane, was filled with an autologous iliac crest bone graft. Bone union rate, time to achieve bone union, length of hospital stay, number of surgeries, infection resolution, range of motion, musculoskeletal tumor society system functional score, limb shortening. The mean defect size was 6.7 cm, and infection was present in 23 (68%) of the bone defects. Bone union was evident in 91% of cases (31/34). The average time to union was 8.5 months. In 7/23 (30%) of infected cases, the infection recurred, and in three of them, the graft was resorbed, resulting in treatment failure. The induced membrane technique was effective for managing post-traumatic bone defects. A recurrence of infection was associated with treatment failure. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.