Induced membrane technique for acute bone loss and nonunion management of the tibia

OBJECTIVES: To report our experience and clinical results of using the Masquelet technique for the treatment of tibial nonunions and acute traumatic tibial bone defects. DESIGN: Retrospective study of prospectively collected data (Level IV). SETTING: Level I trauma center in the UK. PATIENTS/PARTICIPANTS: Consecutive patients with tibial nonunions and open fractures associated with bone loss. Intervention: Two-stage Masquelet Procedure for the tibia. MAIN OUTCOME MEASUREMENTS: Clinical and imaging assessment at 6 weeks, 3,6,9,12 months, or until pain-free mobilization and union. RESULTS: There were 17 eligible patients, with a mean size of bone defect of 6 cm (range, 4–8 cm) and an 88.2% union rate at a mean of 8 months (range 5–18 months). Mean range of motion was 95 degrees of knee flexion (range 80°–130°). All patients but 2 returned to their previous occupation. CONCLUSIONS: The Masquelet technique is simple, effective, and has a high rate of success for the management of a variety of situations including acute bone loss or infected nonunions and is associated with a low incidence of complications.