Surgical repair of large segmental bone loss with the induced membrane technique: patient reported outcomes are comparable to nonunions without bone loss

被引:1
|
作者
Konda, Sanjit R. R. [1 ,2 ]
Boadi, Blake I. I. [1 ]
Leucht, Philipp [1 ]
Ganta, Abhishek [1 ,2 ]
Egol, Kenneth A. A. [1 ,2 ]
机构
[1] NYU Langone Hlth, NYU Langone Orthoped Hosp, 301 E 17Th St,Suite 1402, New York, NY 10003 USA
[2] Jama Hosp Med Ctr, Dept Orthoped Surg, New York, NY 11418 USA
关键词
Segmental bone loss; Nonunion; Induced membrane technique; SMFA; VAS; RECONSTRUCTION; DEFECTS;
D O I
10.1007/s00590-023-03580-4
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
ObjectiveTo compare the outcomes of patients with segmental bone loss who underwent repair with the induced membrane technique (IMT) with a matched cohort of nonunion fractures without bone loss.DesignRetrospective analysis on prospectively collected data.SettingAcademic medical center.PatientsTwo cohorts of patients, those with upper and lower extremity diaphyseal large segmental bone loss and those with ununited fractures, were enrolled prospectively between 2013 and 2020. Sixteen patients who underwent repair of 17 extremities with segmental diaphyseal or meta-diaphyseal bone defects treated with the induced membrane technique were identified, and matched with 17 patients who were treated for 17 fracture nonunions treated without an induced membrane. Sixteen of the bone defects treated with the induced membrane technique were due to acute bone loss, and the other was a chronic aseptic nonunion.Main Outcome MeasurementsHealing rate, time to union, functional outcome scores using the Short Musculoskeletal Functional Assessment (SMFA) and pain assessed by the Visual Analog Scale (VAS).ResultsThe initial average defect size for patients treated with the induced membrane technique was 8.85 cm. Mean follow-up times were similar with 17.06 & PLUSMN; 10.13 months for patients treated with the IMT, and 20.35 & PLUSMN; 16.68. months for patients treated without the technique. Complete union was achieved in 15/17 (88.2%) of segmental bone loss cases treated with the IMT and 17/17 (100%) of cases repaired without the technique at the latest follow up visit. The average time to union for patients treated with the induced membrane technique was 13.0 & PLUSMN; 8.4 months and 9.64 & PLUSMN; 4.7 months for the matched cohort. There were no significant differences in reported outcomes measured by the SMFA or VAS. Patients treated with the induced membrane technique required more revision surgeries than those not treated with an induced membrane.ConclusionOutcomes following treatment of acute bone loss from the diaphysis of long bones with the induced membrane technique produces clinical and radiographic outcomes similar to those of long bone fracture nonunions without bone loss that go on to heal.
引用
收藏
页码:243 / 249
页数:7
相关论文
共 50 条
  • [41] Antibiotic cement spacer and induced membrane bone grafting in open fractures with bone loss: A case series
    Kasha, Srinivas
    Rathore, Sameer Singh
    Kumar, Hemanth
    INDIAN JOURNAL OF ORTHOPAEDICS, 2019, 53 (02) : 237 - 245
  • [42] The induced membrane technique for the management of long bone defects A SYSTEMATIC REVIEW OF PATIENT OUTCOMES AND PREDICTIVE VARIABLES
    Fung, B.
    Hoit, G.
    Schemitsch, E.
    Godbout, C.
    Nauth, A.
    BONE & JOINT JOURNAL, 2020, 102B (12): : 1723 - 1734
  • [43] Preliminary Results of the Induced Membrane Technique for the Reconstruction of Large Bone Defects
    Mansour, Toni M.
    Ghanem, Ismat B.
    JOURNAL OF PEDIATRIC ORTHOPAEDICS, 2017, 37 (01) : E67 - E74
  • [44] Early Results of a Modified Induced Membrane Technique in the Management of Traumatic Bone Loss in the Lower Limb: A Cohort Study
    Giotikas, D.
    Tarazi, N.
    Spalding, L.
    Nabergoj, M.
    Krkovic, M.
    IRISH JOURNAL OF MEDICAL SCIENCE, 2018, 187 : S155 - S156
  • [45] Induced membrane technique for bone loss in the lower limb - Does the Masquelet technique work as well as its' reputation says it does
    Kubik, Jeremy
    Aitken, Stuart
    Buckley, Richard
    INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2022, 53 (02): : 224 - 226
  • [46] Management of Total Femoral Bone Loss Using a Hybrid Cement Spacer Surgical Technique
    Gheiti, Adrian J. Cassar
    Baker, Joseph F.
    Brown, Thomas E.
    Mulhall, Kevin J.
    JOURNAL OF ARTHROPLASTY, 2013, 28 (02): : 347 - 351
  • [47] Induced membrane technique using beta-tricalcium phosphate for reconstruction of femoral and tibial segmental bone loss due to infection: technical tips and preliminary clinical results
    Gen Sasaki
    Yoshinobu Watanabe
    Wataru Miyamoto
    Youichi Yasui
    Shota Morimoto
    Hirotaka Kawano
    International Orthopaedics, 2018, 42 : 17 - 24
  • [48] Induced membrane technique using beta-tricalcium phosphate for reconstruction of femoral and tibial segmental bone loss due to infection: technical tips and preliminary clinical results
    Sasaki, Gen
    Watanabe, Yoshinobu
    Miyamoto, Wataru
    Yasui, Youichi
    Morimoto, Shota
    Kawano, Hirotaka
    INTERNATIONAL ORTHOPAEDICS, 2018, 42 (01) : 17 - 24
  • [49] Staged bone grafting for the management of segmental long bone defects caused by trauma or infection using induced-membrane technique
    El-Hadidi, Talaat Taher
    Soliman, Hesham Mesbah
    Farouk, Hazem Ahmed
    Radwan, Mustafa Abd El-Mogeeb
    ACTA ORTHOPAEDICA BELGICA, 2018, 84 (04): : 384 - 396
  • [50] Antibiotic Cement Spacer and Induced Membrane Bone Grafting in Open Distal End Femur Fractures with Bone Loss; Radiographic and Functional Outcomes: A Retrospective Study
    Patel, Dharmesh
    Singh, Avtar
    Vohra, Rajeev
    Chauhan, Sandeep
    Thorat, Babaji
    TRAUMA MONTHLY, 2021, 26 (04) : 213 - 221