Management of Traumatic Tibial Diaphyseal Bone Defect by “Induced-Membrane Technique”
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 5
Abstract
Background: Gap nonunion of long bones is a challenging problem, due to the limitation of conventional reconstructive techniques more so if associated with infection and soft tissue defect. Treatment options such as autograft with non-vascularized fibula and cancellous bone graft, vascularized bone graft, and bone transportation are highly demanding on the part of surgeons and hospital setups and have many drawbacks. This study aims to analyze the outcome of patients with wide diaphyseal bone gap treated with induced-membrane technique (Masquelet technique). Materials and Methods: This study included 6 patients (6 males), all with tibial bone-gap. This technique is two-stage procedure. Stage I surgery included debridement, fracture stabilization, application of spacer between bone ends, and soft tissue reconstruction. Stage II surgery included removal of spacer with preservation of induced membrane formed at spacer surface and filling the bone-gap with morselized iliac crest bone-graft within the membrane sleeve. Average bone-gap of 5.9 cm was treated. The spacer was always found to be encapsulated by a thick glistening membrane which did not collapse after its removal. All patients were followed up for an average period of 21.5 months. Results: Serial Radiographs showed regular uptake of autograft and thus consolidation within themselves in the region of bone gap and also with host bone. Bone-union was documented in all patients and all patients are walking full weight-bearing without support. Conclusions: The study highlights that the technique provide effective and practical management for difficult gap nonunion. It does not require specialized equipment, investigations, and surgery. Thus, it provides a reasonable alternative to the developing infrastructures and is a reliable and reproducible technique.
Authors and Affiliations
Shankar Niwas
Keywords
Related Articles
- EP ID EP547580
- DOI 10.21276/ijmrp.2017.3.5.051
- Views 96
- Downloads 0
Non-operative Management of Liver Injury among Abdominal Trauma Patients Admitted to Al-Noor Specialist Hospital in Makkah Al-Mukarmah: A Retrospective Cohort Study, 2013 – 2014
Background: Recently, there was a shift in the management plan for liver blunt trauma from operative to non-operative treatment, as there were advances in critical care and sensitivity of diagnostic tools for detection o...
Perforated Duodenal Ulcer Following Roux-en-Y Gastric Bypass (RYGB): Case Report and Literature Review
Roux-en-Y gastric bypass (RYGB) is a common bariatric procedure. one of its rare complication seen is a perforated duodenal ulcer. It’s a surgical emergency which is often misdiagnosed. The cause of such the complication...
A Study to Evaluate the Role of FNAC in Diagnosis of Breast Lesions: A Hospital Based Study
Background: Breast carcinoma is one of the dominant causes of malignancy in females. The conventional diagnostic mode of breast mass is excisional biopsy, which gives accurate diagnosis but may produce a benign pathologi...
Comparative Evaluation of the Efficacy and Safety of Fentanyl and Dexmedetomidine as Adjuvants to Levobupivacaine in Epidural Anaesthesia in Patients Undergoing Hip and Lower Limb Surgeries
Introduction: Epidural anaesthesia is a central neuraxial block with many applications ranging from analgesia with minimal motor block to dense anaesthesia with full motor block. The present study was aimed to compare th...
A Comparative Study to Find Gender Wise Differences in Lumbo-Pelvic Alignment in Patient with Chronic Low Backache
Introduction: In patients with low back pain, radiographic parameters that most highly correlate with patient-reported outcomes are focal i.e, rotatory subluxation, regional i.e, loss of lordosis and global i.e, sagittal...