Abstract
Introduction Gunshot-related open fractures are at risk for significant bone loss. Consolidation is unlikely in defects larger than 2 cm. The induced membrane technique (IMT) results in the formation of a membrane to facilitate consolidation. We present two cases of gunshot-related open fracture progressing with infected non-union and bone defects and their subsequent management with IMT.
Cases We present two cases of open fracture of the distal femur secondary to a gunshot wound. Initially, the two cases underwent external fixation followed by an intramedullary nail (IMN) placement. Both progressed with infected non-union and a 4-cm bone defect. IMT resulted in infection control and fracture consolidation.
Discussion IMT was a successful salvage surgery for bone defects secondary to an infected femoral non-union. Managing bone defects is challenging due to infection, soft tissue loss, bone gap, and fracture healing potential. IMT is an attractive alternative for treating bone defects bigger than 2 cm since the repair is independent of the defect size and allows infection control.
Conclusion IMT is an effective salvage technique for the management of bone defects caused by gunshots. It allows limb salvage and comprehensively manages the several aspects requiring consideration in these cases.
Keywords
induced membrane technique - bone defect - infected non-union
