This retrospective case series examines real-world outcomes of the two-stage Masquelet (induced membrane) technique for large segmental bone defects. It asks: what union rate does this technique achieve in a trauma population, and what factors actually predict failure? 69 patients were followed for a mean of 23.8 months at a Level I trauma center.
Large segmental bone defects in trauma patients historically required distraction osteogenesis, free vascularized fibula transfer, or amputation — all with significant morbidity and prolonged treatment timelines. The Masquelet technique offered a simpler two-stage alternative, but real-world outcomes data from trauma populations were limited at the time of this publication.
This series clarifies where failures actually come from: it is not defect size, tobacco use, fixation choice, or graft type. When you are planning stage 2, optimizing soft tissue coverage and controlling infection are the highest-yield interventions available.
When positive intraoperative cultures appear at stage 2, do not automatically abandon the construct. This paper supports retaining the graft and implants with 6 weeks of IV antibiotics. 4 of 6 such patients in this series still achieved union.
Target spacer dwell time of 6–8 weeks for optimal membrane maturation, and flag any case drifting past 20 weeks, as membrane quality appears to decline beyond that point.
This retrospective case series examines real-world outcomes of the two-stage Masquelet (induced membrane) technique for large segmental bone defects. It asks: what union rate does this technique achieve in a trauma population, and what factors actually predict failure? 69 patients were followed for a mean of 23.8 months at a Level I trauma center.
Large segmental bone defects in trauma patients historically required distraction osteogenesis, free vascularized fibula transfer, or amputation — all with significant morbidity and prolonged treatment timelines. The Masquelet technique offered a simpler two-stage alternative, but real-world outcomes data from trauma populations were limited at the time of this publication.
This series clarifies where failures actually come from: it is not defect size, tobacco use, fixation choice, or graft type. When you are planning stage 2, optimizing soft tissue coverage and controlling infection are the highest-yield interventions available.
When positive intraoperative cultures appear at stage 2, do not automatically abandon the construct. This paper supports retaining the graft and implants with 6 weeks of IV antibiotics. 4 of 6 such patients in this series still achieved union.
Target spacer dwell time of 6–8 weeks for optimal membrane maturation, and flag any case drifting past 20 weeks, as membrane quality appears to decline beyond that point.