InducedMembranes—AStagedTechniqueofBone-GraftingforSegmentalBoneLoss.docxVIP

Induced Membranes—A Staged Technique of Bone-Grafting for……Induced Membranes—A Staged Technique of Bone-Grafting for Segmental Bone Loss诱导膜是骨移植修复部分骨缺损的一项阶段性的技术Diaphyseal defects too long to be bridged by cancellous bone graft require complex reconstruction.Distraction osteogenesis requires specialized equipment,has a steep learning curve,and is plagued by attendant pin-site complications and nonunion .Vascularized bone,such as from the fibula,requires microsurgical anastomoses(free),or is limited by pedicle length(pedicled),and has attendant donorsite morbidity(both free and pedicled).采用松质骨修复长段骨缺损需要复杂的修复重建过程。牵引成骨技术需要专门的设备，病程较长，以及随之而来的是针道感染等并发症和骨不连的困扰。带血运的骨移植如腓骨移植，游离移植需要显微外科技术，局部转移往往受血管蒂的长度所限，并且无论游离移植还是局部转移都会造成供区的损伤。The French technique of bone-grafting within induced membranes,otherwise known as the Masquelet technique, offers a viable alternative with minimal complications .In this technique,a cement spacer is placed in a posttraumatic bone defect.Its presence serves a twofold function of preventing fibrous ingrowth into the bone gap,and inducing the formation of specialized tissue or so-called induced membranes around it.Bone graft placed within this tube of induced membranes incorporates into functioning bone.这项法国的骨诱导膜骨移植术，也就是已知Masquelet技术，提供了切实可行的方法，同时几乎没有并发症。在这一技术中，水泥间隔放置在创伤造成的骨缺损处。它的主要作用是防止纤维组织填充骨缺损区域，另外在其周围诱导形成特殊的组织即所谓的诱导膜。移植骨和骨诱导膜管共同作用形成新生骨修复骨缺损。We present the case of a patient with diaphyseal bone loss and the case of a patient with epimetaphyseal bone loss, both with ongoing bacterial contamination,successfully treated by this procedure.Both patients were informed that data concerning the case would be submitted for publication,and they consented.我们治疗了一位骨干骨质缺损的患者和一例干骺端缺损的患者，两例均为开放性污染创面，采用这一技术的治疗均治愈，经两位患者同意后，病历资料汇报如下：Case Reports病例报道CASE 1.A twenty-year-old woman was struck by an automobile while crossing the road.She sustained an open (Gustilo-IIIdiaphyseal fracture of the left tibia(AO-OTA42-C3)with marked loss of the soft-tissue envelope over the medial,