{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:06:03Z","timestamp":1792004763235,"version":"4.4.0"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Several modifications of the induced membrane technique (IMT) have been reported, but there is no consensus regarding their results and prognosis. Moreover, most studies have focused on tibial defects; no meta\u2010analysis of the treatment of femoral defects using the IMT has been reported. This systematic review and meta\u2010analysis aimed to identify the potential risk factors of post\u2010procedural complications following the treatment of segmental femoral defects using the IMT. A comprehensive search was performed on the Cochrane Library, EBSCO, EMBASE, Ovid, PubMed, Scopus, and Web of Science databases, using the keywords \u201cfemur,\u201d \u201cMasquelet technique,\u201d and \u201cinduced membrane technique.\u201d Original articles composed in English, having accessible individual patient data, and reporting more than two cases of bony defect or nonunion of femur or more than five cases of any body part were included. Post\u2010procedural bone graft infections, final union status, and union time after second\u2010stage operation were analyzed. Fourteen reports, including 90 patients, were used in this study. External fixation in second\u2010stage surgery had an odds ratio of 9.267 for post\u2010procedural bone graft infection (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.047). The odds ratio of post\u2010procedural bone graft infection and age\u2009&gt;65\u2009years for final non\u2010union status was 51.05 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.003) and 9.18 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.042). Shorter union time was related to impregnated antibiotics in the spacer (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.005), transplanting all\u2010autologous grafts (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.042), and the application of intramedullary nails as the second\u2010stage fixation method (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.050). The IMT appears to be reasonable and reproducible for femoral segmental bone defects. Several preoperative and surgical factors may affect post\u2010procedural complications and union time.<\/jats:p>","DOI":"10.1111\/os.13604","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T12:24:45Z","timestamp":1669724685000},"page":"28-37","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Induced Membrane Technique for the Management of Segmental Femoral Defects: A Systematic Review and <scp>Meta\u2010Analysis<\/scp> of Individual Participant Data"],"prefix":"10.1111","volume":"15","author":[{"given":"Yi","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Musculoskeletal Research Center Chang Gung Memorial Hospital and Chang Gung University  Tao\u2010Yuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Yang","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic 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