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Tibial segmental bone defect reconstruction by Ilizarov type bone transport in an induced membrane

2010; Elsevier BV; Volume: 96; Issue: 2 Linguagem: Inglês

10.1016/j.otsr.2009.10.017

1877-0568

A.-P. Uzel, F. Lemonne, Vincent Casoli,

Orthopaedic implants and arthroplasty

The management of combined loss of skin coverage and bone substance in the lower third of the leg is problematic. A recommended sequential strategy associates removal of infected tissue and coverage followed by treatment of the bone defect. We report a technique without microsurgery, using Masquelet's induced membrane technique to manage the bone loss, associated to bone transport and coverage by a fasciocutaneous flap with distal pedicle. In a patient presenting with a 10 cm defect with bone exposure, this 2-step procedure allowed consolidation at 7 months without functional sequelae; the fixator was kept in place for 9 months. Neither microsurgery nor cancellous bone graft was required. Using a spacer to induce a membrane facilitated bone transport and distal consolidation.