Muscle reconstruction in reconstructive surgery: soft tissue repair and long bone reconstruction

Background. We report a series of reconstructions of long bone defects in 35 patients. Bone defects ranged from 5.0 to 25.0 cm. Method. Reconstruction was performed in two stages. The first stage was the insertion into the defect of a cement spacer, which was responsible for the formation of a pseudosynovial membrane. A soft tissue repair employing a flap was done in the same operating time in 28 cases. The second stage was the reconstruction of the bone defect by a large, fresh, autologous cancellous bone graft. Results. The membrane induced by the spacer prevents the resorption of the graft and favours its revascularisation and its corticalisation. Experimental study has also shown that the membrane plays the role of an 'in situ growth-factors delivery system'. Conclusion. In weight-bearing diaphyseal segments normal walking was possible at 8.5 months on average.