Validation of masquelet technique excluding the septic context: Management of open comminuted fractures in the acute trauma

Abstract

Background: in its initial conception over three decades ago, the induced membrane (IM) technique was specifically developed to address bone loss in cases of septic pseudarthrosis of the lower limb. This technique has proven effective in instances of acute post-traumatic bone loss resulting from high-energy trauma, particularly in scenarios where shattered fractures require more than conservative osteosynthesis. Methods: in this report, we share our department's experience in managing such fractures using the induced membrane technique. Results: All patients underwent initial external fixation or centromedullary nailing, followed by corticocancellous grafting or vascularized fibula grafting in the second stage. The bone healing process was assessed through standard X-rays with two views, anteroposterior and lateral, of the affected limb segment, and clinical evaluation was performed using specific functional scores. The average follow-up for our patients was 8.54 months. Conclusion: while effective for substance loss from sepsis or septic pseudarthrosis, the induced membrane technique's broader use, notably in severe open fractures with substantial bone comminution, remains underexplored. Our practice's adoption of this method enhances its applicability and value.

Keywords

• Shattered fractures
• Induced membrane technique
• Bone defect
• Acute trauma
• Cement