Induced Membrane (Masquelet) technique in treatment of long bone defects

Abstract

Long bone defects represent a major, unsolved clinical challenge in orthopaedic practice. Critical size bone defects are defined as defects exceeding 2–2.5times the diameter of the affected bone. Bone defects may result from high-energy trauma, infection, or revision surgery. Bone defects are often associated with unfavorable soft tissue conditions and concomitant infections. Their successful management depends upon infection control, proper soft tissue coverage, restoration of a sufficient vascular supply and regeneration of bone at the site of the defect. Since 1986, Masquelet et al. revealed the osteogenic potential of an induced membrane generated at the bone defect site in a two-stage surgical procedure. This approach involves the complete removal of all devitalized tissue, followed by proper soft tissue reconstruction and insertion of polymethylmethacrylate (PMMA) spacer to fill the existing bone void.