Challenges of the induced-membrane technique in the reconstruction of traumatic tibial defect with limited resources : a cohort study


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Published online: Apr 16 2021

Laurent Mathieu, Loïc Potier, René Ndiaye, Camille Choufani, Elimane Mbaye, Coumba-Diouf Niang

Department of orthopedics, traumatology and reconstructive surgery, Percy Military Hospital, Clamart, France


This study sought foremost to evaluate the outcomes of applying the induced membrane technique (IMT) for tibia reconstruction within the context of a sub-Saharan Africa trauma center. Second, this study aimed to elucidate the conditions of IMT usage in a limited-resource setting.

A retrospective study was performed among patients treated via IMT for posttraumatic tibial bone defects who had follow-up data available for at least 12 months.

Eleven patients with a mean age of 36 years were included. All presented with an infected multi-tissue defect. The mean length of the tibia defect was 4.4 cm and the mean area of the soft-tissue loss was 32 cm2 . Pedicled flap coverage was required in all cases. At the mean follow-up time of 15 months bone union was achieved in nine of 11 cases, after additional inter-tibiofibular grafting was performed in four cases. Infection recurrence was noted in five of 11 cases. Most patients presented medium-quality soft-tissue coverage and suboptimal function.

IMT may represent a valuable option for tibia reconstruction with limited surgical resources in cases where appropriate infection control and stable soft-tissue coverage can be ensured.