Back to Search
Start Over
Preliminary Results of the Induced Membrane Technique for the Reconstruction of Large Bone Defects
Preliminary Results of the Induced Membrane Technique for the Reconstruction of Large Bone Defects
- Source :
- Journal of Pediatric Orthopaedics. 37:e67-e74
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Background During past decades, gradual bone transplant using external fixators and vascularized fibular or rib transplants widely contributed to solve difficult problems related to the reconstruction of large bone defects in children. However, these surgeries are time consuming and require specialized surgical skills, not always available in a general hospital setting, mainly in rural areas. Purpose To report the preliminary results of the more recently described induced membrane technique in a consecutive series of 8 children and to identify some factors related to the procedure's success. Methods Nine consecutive children with bone defects ranging from 5 to 14 cm were included in the study. The age at surgery ranged from 3 to 16 years. There were 3 congenital pseudarthrosis (CP) of the fibula, 1 CP of the tibia, 1 Ewing sarcoma of the tibia, 1 Ewing sarcoma of the ulna, 1 tibial osteosarcoma, 1 fibular osteosarcoma, and 1 chronic diffuse tibial osteomyelitis. The procedure was performed according to the original Masquelet's description in 2 stages. Follow-up ranged from 1 to 7 years. Results The child with tibial osteosarcoma died 3 months after the surgery from complications related to chemotherapy. Among the 8 remaining children, 6 healed uneventfully, and 2 required revision with additional grafting and/or better internal fixation, one with Ewing sarcoma of the tibia and a 13-cm bone defect and the second with CP of the fibula. Both of them had suboptimal internal stabilization. Conclusions The induced membrane technique is a useful, efficient, and simple alternative to highly specialized surgical procedures used for the reconstruction of large bone defects in children. Risk factors for failure include chemotherapy, suboptimal bone fixation, and persistent axial malalignment. Level of evidence Level IV.
- Subjects :
- Male
Reoperation
musculoskeletal diseases
medicine.medical_specialty
Adolescent
External Fixators
medicine.medical_treatment
Bone Neoplasms
Ulna
Sarcoma, Ewing
Fracture Fixation, Internal
03 medical and health sciences
0302 clinical medicine
Fracture fixation
medicine
Humans
Internal fixation
Orthopedics and Sports Medicine
Tibia
Fibula
Child
Retrospective Studies
Osteosarcoma
030222 orthopedics
Bone Transplantation
business.industry
Osteomyelitis
Bone Cements
General Medicine
Plastic Surgery Procedures
medicine.disease
Surgery
Pseudarthrosis
Treatment Outcome
medicine.anatomical_structure
Child, Preschool
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Female
Sarcoma
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 02716798
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Orthopaedics
- Accession number :
- edsair.doi.dedup.....618eb6a416b2a37cf4c7fe634a29f940
- Full Text :
- https://doi.org/10.1097/bpo.0000000000000663