The Masquelet induced-membrane technique: an option for a tertiary-referral conflict setting

A post-traumatic, infected, non-union of a long bone is a significant challenge to orthopaedic surgeons, especially in zones of conflict and humanitarian settings. We describe a 32-year-old man treated with the two-stage Masquelet procedure for an infected non-union, and the processes required to achieve clinical bony union. The initial injury was a gunshot wound through the left proximal tibia, which lay untreated for three months before the first definitive surgical procedure. Subsequent management required 13 procedures over 18 months with clinical union being achieved 4.5 years after wounding. The management of an infected non-union of a long bone in zones of conflict is difficult. However, a successful outcome is still possible and the Masquelet procedure a suitable choice; amputation is not always the correct solution. There is a need in the humanitarian sector for healthcare facilities within easy reach of a zone of conflict that can undertake complex reconstructive procedures.