Reconstruction of a tibial diaphyseal bone defect using the Masquelet technique. A case report

Segmental bone defects in the lower limb may be treated by distraction osteogenesis, vascularized bone grafts, allografts, metal prostheses or amputation. The induced membrane technique, introduced by Masquelet, consists in induction of a pseudo-synovial membrane by local tissue reaction to a synthetic spacer, followed by application of bone allograft to the resulting cavity. This article describes the case of a 34-year-old male with severe multiple trauma. The patient's injuries included a Gustillo-Anderson type IIIa open tibial shaft fracture, treated by means of the fix and flap technique. Application of the fix and flap technique resulted in a 7 cm bone defect that was filled using the induced membrane technique. This case report includes a review of the existing literature and a description of the modifications that have been proposed to the original Masquelet technique, including the use of antibiotic-impregnated cement, extension of the interval between the two surgical stages, and the use of alternative osteosynthesis materials.