Similarities and Differences of Induced Membrane Technique Versus Wrap Bone Graft Technique

Yongwei Wu; Qudong Yin; Zihong Zhou; Sanjun Gu; Yongjun Rui; Fengfeng Li

doi:10.1007/s43465-019-00006-4

Similarities and Differences of Induced Membrane Technique Versus Wrap Bone Graft Technique

Indian J Orthop. 2020 Jan 24;54(2):156-163. doi: 10.1007/s43465-019-00006-4. eCollection 2020 Apr.

Authors

Yongwei Wu^#¹, Qudong Yin¹, Zihong Zhou², Sanjun Gu¹, Yongjun Rui^#¹, Fengfeng Li¹

Affiliations

¹ 1Department of Orthopaedics, Wuxi No. 9 People's Hospital Affiliated to Soochow University, No. 999 Liangxi Road, Wuxi, 214062 Jiangsu China.
² 2Orthopaedic Department, Wuxi People's Hospital, Wuxi, 214000 Jiangsu China.

^# Contributed equally.

Abstract

Background: There are no reports on the similarities and differences between induced membrane (IM) technique and wrap bone graft(WBG) technique.

Objective: The aims of this study are to investigate the effects of IM technique and WBR technique in repairing segmental bone defects, and to analyze the similarities and differences between them.

Materials and methods: 66 patients of tibial segmental bone defects treated by IM technique and WBG technique were retrospectively analyzed. Aged 13-69 years old with an average of 35.3 years old. IM technique was divided into early IM group (bone grafting at 6-8 weeks of bone cement filling) and late IM group (bone grafting after 8 weeks of bone cement filling). WBG was divided into titanium mesh group and line suturing cortical bone blocks group. There were 11 cases, 25 cases, 10 cases and 20 cases in the early IM group, late IM group, titanium mesh group and line suturing group, respectively. Bone healing, complications and functional recovery (Paley's method) were observed, the causes of nonunion and delayed union and factors affecting bone healing were analyzed.

Results: There were no significant differences in terms of age, sex, defect length, course, fixation method, defect location and preoperative function of adjacent joints among the 4 groups. All patients were followed up for 12-50 months, with an average of 20.1 months. The clinical healing time of early IM group, late IM group, titanium mesh group and line suturing group were (5.81 ± 0.75) months, (7.56 ± 1.66) months, (7.50 ± 0.70) months and (7.81 ± 1.81) months, respectively, showing significant differences among the 4 groups (P = 0.005). However, only early IM group had significant difference with other groups (P < 0.05), while no significance was found between late IM group and WBR group, between titanium mesh group and suture group (P > 0.05). There were no significant differences in healing ration, complications and functional recovery of adjacent joints among the 4 groups (P > 0.05). There were 4 cases of nonunion and delayed union, all of which were caused by poor quantity or quality of bone graft or unstable bone graft or internal fixation.

Conclusion: Both IM technique and WBG technique are effective method for repairing segmental bone defects. In addition to mechanical encapsulation, early IM has biological osteogenesis. However, mechanical encapsulation is a common basis for repairing bone defects, and biological osteogenesis can enhance bone healing.

Keywords: Bone healing; Induced membrane technique; Line mesh; Segmental bone defect; Titanium mesh; Wrap bone graft technique.