Repair of tibial bone defects with fibular fragment and the induced membrane technique

Mitrofanov A.I., Al Delamy O.K., Al Harris M.S.


High-energy tibial fractures are challenging injuries to treat.
We report a case of a tibial gunshot fracture treated at several stages.
Material and methods
The fracture was first stabilized with external fixation device. The second stage aimed at the arrest of infection consisted of excision of necrotic tissues, placement of antibacterial spacer and repair of compromised soft tissues. Reconstructive surgery was produced at the third stage of treatment to address bone defect and provide consolidation.
Results and discussion
The Masquelet induced membrane technique, compression osteosynthesis with the Ilizarov frame and non-free autograft using fibular fragment facilitated recovery of supporting tibia functions within a relatively short period of time.
The combination of stimulating effects from different surgical techniques is useful to ensure a good outcome in a severe clinical case scenario.


bone defect, Ilizarov technique, autograft, Masquelet membrane

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