Efficacy and complications of the induced membrane technique for immediate bone reconstruction in complex hand injuries.

PURPOSE: To report the radiological outcomes and complications of the Masquelet induced membrane technique (IMT) for acute bone reconstruction in complex hand injuries.

METHODS

We retrospectively reviewed 22 patients treated primarily by the IMT for bone defect of the phalanx and/or metacarpals bones in 26 injured digits. The median bone defect length was 17 mm (IQR 13-25). Given the severity and variability of the lesions, revision parameters focused on bone healing and postoperative complications.

RESULTS

At the median follow-up of nine months (IQR, 6-14 months), bone union was achieved in 25 digits (96%) with a median delay of three months (IQR, 2.5-3.5 months) after stage 2. Postoperative complications occurred in 11 of 26 digits requiring revision surgery in nine of 26 digits (35%). Soft tissue coverage failure and infection were the main complications. A patient underwent a late amputation through the metacarpophalangeal joint due to an uncontrolled bone infection.

CONCLUSIONS

Despite a significant rate of complications, bone reconstruction using the IMT is a reliable procedure for achieving bone healing of phalanx or metacarpal bone defects in complex hand injuries.