Induced Membranes—A Staged Technique of Bone-Grafting for Segmental Bone Loss

Chong, K.W.; Woon, Colin Yi-Loong; Wong, Michael

doi:10.2106/jbjs.j.01251

Cited by 29 publications

(19 citation statements)

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“…This cement spacer also induces the formation of biomembrane as a foreign body reaction to itself. It prevents ingrowth of fibrous tissue and maintains a well-defined void for later placement of graft and also gives structural support to the construct 91213. In addition, it helps the plastic surgeon by eliminating dead space and providing a base for putting up flaps for wound coverage.…”

Section: Discussionmentioning

confidence: 99%

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Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Fractures with Bone Loss: A Case Series

Kasha

Rathore

Kumar

2019

IJOO

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Background:Open fractures are a difficult entity, often complicated by infection and nonunion. Bone loss in such fractures adds to the complexity. Conventional techniques of bone defect management are mainly directed toward fracture union but not against preventing infection or joint stiffness. In this case series, we evaluated Masquelet's technique for management of open fractures with bone loss.Materials and Methods:Twenty seven open fractures with bone defect, which presented within 3 days of trauma were planned for treatment by Masquelet's technique. Followup ranged from 21 to 60 months.Results:Average length of bone defect was 6 cm. Radiological union was obtained at a mean of 280 days since first stage of surgery. Time for union was not related to the size of defect. Union was faster in metaphyseal region (265.6 ± 38.8 days) as compared to diaphysis (300.9 ± 58.6 days). No patient had residual infection after stage 1. All the patients were able to mobilize with full weight bearing after radiological union with a satisfactory range of motion of adjacent joints.Conclusion:This technique can be routinely applied in compound fractures with bone loss with good results. Chances of infection are reduced using antibiotic cement spacer as an adjunct to thorough debridement. Induced biomembrane revascularizes the graft. Union can be expected in most of the cases, however, long time to union is a limitation. Technique is cost-effective and does not require special training or instrumentation. Although it is a two-stage surgery, requirement of multiple surgeries, as may be needed in conventional methods, is avoided.

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Section: Discussionmentioning

confidence: 99%

“…Biomembrane is the workhorse in this technique, characteristics of which have been highlighted by various researchers. It prevents graft resorption, promotes vascularity, and corticalization 91214. Histologic and immunochemistry studies were performed and the following data have been established:131415…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Fractures with Bone Loss: A Case Series

Kasha

Rathore

Kumar

2019

IJOO

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“…The Masquelet technique is an effective two-stage method to enhance bone reconstruction by creating a vascularized soft tissue envelope before grafting of bone defects [1,3,5,8,13,14,16,23,27]. Enhancing bone formation with the use of the Masquelet induced-membrane method and characterization of the biologic features of the induced membrane have the potential to improve the clinical care of patients who require bone regeneration procedures to treat critical segmental bone defects.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Surgical Technique and Spacer Texture on Bone Regeneration: A Caprine Study Using the Masquelet Technique

Luangphakdy

Pluhar

Piuzzi

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…9 Another important purpose which the spacer serves is that the block placed between the gap helps the soft tissue to not collapse at the fracture site 8 and the space is maintained for subsequent bone grafting. 10 In this case report the presence of induced membrane was documented by visual inspection of the fracture gap after removal of cement spacer. In our patient infection was present in the region of segmental bone loss.…”

Section: 45mentioning

confidence: 88%

Induced membrane formation in a case of infected gap nonunion of radius: Case report

Ahmad

Kalra

Selvamari

2013

Journal of Clinical Orthopaedics and Trauma

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Induced membrane formation a b s t r a c tInfected gap nonunion in long bone fractures is a common problem seen in our setup after compound injuries. Treatment options are limited such as Ilizarov ring fixation with bone transport, vascularised bone graft etc. These techniques require expertise and are associated with their own morbidity and complications. A novel technique called as induced membrane formation, is used to bridge a gap nonunion of more than 5 cm using bone cement as a spacer in first stage and autologous cancellous bone graft to fill the gap once infection is healed along with a bridging plate in second stage.

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Induced Membranes—A Staged Technique of Bone-Grafting for Segmental Bone Loss

Cited by 29 publications

References 0 publications

Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Fractures with Bone Loss: A Case Series

Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Fractures with Bone Loss: A Case Series

The Effect of Surgical Technique and Spacer Texture on Bone Regeneration: A Caprine Study Using the Masquelet Technique

Induced membrane formation in a case of infected gap nonunion of radius: Case report

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