The Induced Membrane Technique: A Therapeutic Option for Managing Bone Defects in the Upper Extremity: Case Series for 7 Patients

Introduction: The reconstruction of bone defects of tumoral, infectious or traumatic origin of the limbs remains a major therapeutic challenge for the orthopedic surgeon and the patient, in terms of anatomical and functional results.

Cases Presentation: We report the case of 7 patients who underwent induced membrane bone reconstruction of the upper extremity, 5 patients with initial injury to the forearm, and 2 of our patients, to the humerus. In terms of function, the range of prono-supination was 125°, the range of wrist flexion-extension was 165°, and the range of elbow mobility was 170°. All patients achieved union at the time of the last follow-up. Two patients achieved union at 6 months, one patient at 5 months, one patient at 4 months, and three patients at 3 months.

Discussion: The induced membrane (IM) technique has been used for more than 30 years, and it's more and more widely accepted all over the world, as a simple and effective technique for reconstruction of segmental bone defects. The technique comprises 2 surgical stages, The first step involves the total excision of infected and non-viable lesions both bone and soft tissue until tissue with optimal vascularization "Paprika sign", then the strict instrumental stabilization of the skeleton and the realization of a covering flap if necessary, depending on the site of the initial injury initial lesion and the extent of the resection.

Conclusion: The technique of induced membrane has proven its effectiveness in the management of bone loss.