Metacarpal bone reconstruction by a cementless induced membrane technique.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Regenerative Medicine

Background:

• Gunshot wounds to the hand frequently cause complex injuries with significant segmental bone defects, posing a reconstructive challenge.
• The induced membrane technique offers a viable solution for segmental bone defect reconstruction, though typically requires polymethylmethacrylate (PMMA) cement.

Observation:

• This study explored adapting the induced membrane technique in a limited-resource environment where PMMA cement was unavailable.
• Two patients with metacarpal bone defects from gunshot wounds were treated using a polypropylene syringe body as a spacer instead of PMMA cement.

Findings:

• A robust induced membrane formed around the polypropylene spacer within 6 weeks in both treated patients.
• Successful bone union was achieved in all four cases of metacarpal reconstruction, including the two treated with the syringe body modification.

Implications:

• This adaptation demonstrates the induced membrane technique's versatility and potential for successful bone reconstruction even without standard materials.
• The findings suggest a cost-effective and accessible alternative for treating complex bone defects in resource-limited settings, improving patient outcomes.