The segmental bone loss resulted from osteomyelitis or after high energy trauma is one of the great challenges facing trauma surgeons.
Patients and methods: twenty four patients 20 males and 4 female with large bone defect resulted after posttraumatic bone loss with potentially infected wound were treated by the two-stage induced membrane technique. The patients included in this study had bone defect of mean (6 cm) – (range 4-8 cm) due to acute bone loss. The mean age of the patients was 24 years ranged from (14 to 36). Clinically, the patients were examined for wound problem, pin tract infection (PTI). Radiologically, the assessment of bone growth and consolidation on serial x-rays. The mean time for removal of external fixator was 12 weeks (range: 9 -16 weeks) after complete healing of the bone graft. Long leg cast was done after removal of external fixator for 6-10 weeks to protect the bone from refracture.
Results: The mean follow up period was 24 months (range 18-36 months). There was significant relation between the size of the defect and the time of healing as the bigger the defect, the longer the time needed for healing. The average external fixation index in this study is 1.8 (range: 1.5 to 2 months/cm). Radiologically, there was angular deformity of 10°-15° in healed cases. The lost range of knee flexion ranged from 20–30° when compared to the other side. There was no loss of hip range of motion in all patients.
Conclusion: The induced membrane technique is a simple and valid technique for the reconstruction of posttraumatic bone defects after debridement of bone fragments and lost bone.