Induced membrane technique with sequential internal fixation: use of a reinforced spacer for reconstruction of infected bone defects

Laurent, Michel; Tossou-Odjo, Léon; l’Escalopier, Nicolas de; Demoures, Thomas; Baus, A.; Brachet, M.; Masquelet, A. C.

doi:10.1007/s00264-020-04735-2

Cited by 12 publications

(23 citation statements)

References 17 publications

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“…The first phase consists of debridement, followed by the insertion of a polymethylmethacrylate spacer into the bone defect [ 78 – 80 ]. Polymethylmethacrylate causes a mild foreign-body inflammatory response which induces the development of a thick pseudo-synovial membrane which acts as a newly performed periosteum [ 78 , 79 , 81 , 82 ]. This pseudomembrane is highly vascularized and rich in growth factors [ 78 , 79 ].…”

Section: Reconstruction Using Biological Materialsmentioning

confidence: 99%

“…Polymethylmethacrylate causes a mild foreign-body inflammatory response which induces the development of a thick pseudo-synovial membrane which acts as a newly performed periosteum [ 78 , 79 , 81 , 82 ]. This pseudomembrane is highly vascularized and rich in growth factors [ 78 , 79 ]. The second phase, which begins after 6–8 weeks, involves opening the membrane and removing the spacer, replacing it with a bone graft [ 4 , 25 , 79 , 83 ].…”

Section: Reconstruction Using Biological Materialsmentioning

confidence: 99%

“…This pseudomembrane is highly vascularized and rich in growth factors [ 78 , 79 ]. The second phase, which begins after 6–8 weeks, involves opening the membrane and removing the spacer, replacing it with a bone graft [ 4 , 25 , 79 , 83 ]. The spacer is a local antibiotic carrier, it reduces dead space, and, for this reason, it is especially indicated in the management of infected bone defects [ 25 , 83 ].…”

Section: Reconstruction Using Biological Materialsmentioning

confidence: 99%

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Strategies for large bone defect reconstruction after trauma, infections or tumour excision: a comprehensive review of the literature

et al. 2021

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Large bone defects resulting from musculoskeletal tumours, infections, or trauma are often unable to heal spontaneously. The challenge for surgeons is to avoid amputation, and provide the best functional outcomes. Allograft, vascularized fibular or iliac graft, hybrid graft, extracorporeal devitalized autograft, distraction osteogenesis, induced-membrane technique, and segmental prostheses are the most common surgical strategies to manage large bone defects. Given its optimal osteogenesis, osteoinduction, osteoconduction, and histocompatibility properties, along with the lower the risk of immunological rejection, autologous graft represents the most common used strategy for reconstruction of bone defects. However, the choice of the best surgical technique is still debated, and no consensus has been reached. The present study investigated the current reconstructive strategies for large bone defect after trauma, infections, or tumour excision, discussed advantages and disadvantages of each technique, debated available techniques and materials, and evaluated complications and new perspectives.

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Section: Reconstruction Using Biological Materialsmentioning

confidence: 99%

Section: Reconstruction Using Biological Materialsmentioning

confidence: 99%

Section: Reconstruction Using Biological Materialsmentioning

confidence: 99%

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Strategies for large bone defect reconstruction after trauma, infections or tumour excision: a comprehensive review of the literature

et al. 2021

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“…The reconstruction of segmental bone defects remains a challenge for military orthopedic surgeons, especially in cases of missile or blast injuries characterized by a high proportion of multi-tissue and infected defects [1][2][3][4][5]. Treatment modalities include techniques such as autologous bone graft (ABG), bone transport, vascularized bone transfer, and the two-stage Masquelet induced membrane (IM) technique (IMT; Table 1) [6,7].…”

Section: Introductionmentioning

confidence: 99%

Masquelet technique in military practice: specificities and future directions for combat-related bone defect reconstruction

Mathieu

Mourtialon

Durand³

et al. 2022

Military Med Res

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Because of its simplicity, reliability, and replicability, the Masquelet induced membrane technique (IMT) has become one of the preferred methods for critical bone defect reconstruction in extremities. Although it is now used worldwide, few studies have been published about IMT in military practice. Bone reconstruction is particularly challenging in this context of care due to extensive soft-tissue injury, early wound infection, and even delayed management in austere conditions. Based on our clinical expertise, recent research, and a literature analysis, this narrative review provides an overview of the IMT application to combat-related bone defects. It presents technical specificities and future developments aiming to optimize IMT outcomes, including for the management of massive multi-tissue defects or bone reconstruction performed in the field with limited resources.

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“…However, due to the need to control infections and reconstruction during the second stage, external xation is not the best choice. Retention of the external xator and alternative internal xation can be used to reconstruct bone defects [6,7]. However, there is no consensus on the best approach.…”

Section: Introductionmentioning

confidence: 99%

Non-contact locking plate application in second stage treatment of post-traumatic tibial osteomyelitis: A retrospective analysis

Chen

Zhu

et al. 2022

Preprint

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Objective: We compared the fixation endurance, bone union time, lower limb joint function and complications associated with external fixation, internal fixation and non-contact locking plate during the treatment of bone defects caused by post-traumatic osteomyelitis debridement. Methods: This retrospective study involved the clinical data for 55 cases with post-traumatic-infected bone defects of the lower extremities, who had undergone radical debridement between January 2017 and September 2020. Moreover, demographics, the time of union, bacterial culture results, complications and the Self-Rating Anxiety Scale scores were statistically compared among the three groups.Results: Differences in bone union time and recurrence rates of osteomyelitis among the three groups were not significant. In contrast, relative to the other two groups, functions after surgery were significantly high in the non-contact locking plate group. Eight patients (8/22 36.4%) in the EX group, four patients (4/13 30.8%) in the IX group and four patients (4/20 20%) in the LP group had shortened limb and deformed tibia. SAS assessment showed that patients in the LP group had the lowest moderate anxiety and severe anxiety rates.Conclusions: The non-contact locking plate technique can achieve a stable fixation with non-contact between the implant and bone tissues. Therefore, it is a viable alternative for second-stage treatment of post-traumatic tibial osteomyelitis.

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Induced membrane technique with sequential internal fixation: use of a reinforced spacer for reconstruction of infected bone defects

Cited by 12 publications

References 17 publications

Strategies for large bone defect reconstruction after trauma, infections or tumour excision: a comprehensive review of the literature

Strategies for large bone defect reconstruction after trauma, infections or tumour excision: a comprehensive review of the literature

Masquelet technique in military practice: specificities and future directions for combat-related bone defect reconstruction

Non-contact locking plate application in second stage treatment of post-traumatic tibial osteomyelitis: A retrospective analysis

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