Clinical Observation Of Masquelet Technique In Treatment Of Chronic Osteomyelitis Bone Defects Of Long Bones

Objective To evaluate the clinical outcomes of Masquelet technique in the treatment of chronic osteomyelitis bone defects of long bones.Methods Our department used Masquelet technique to treat segmental bone defects caused by chronic osteomyelitis of long bone.We screened patients with chronic osteomyelitis hospitalized in our department from September 2016 to December 2018.A total of 29 patients were enrolled in this study.The operation was divided into two stages,the first was the treatment of bone infection and the second was the reconstruction of bone defect.The clinical and imaging results of all patients were analyzed retrospectively.According to imaging and function,the healing of bone graft and the recovery of limb function by Masquelet were evaluated.Imaging evaluation was mainly based on Samantha X-ray scoring system to evaluate the growth of callus.Johner-Wruch standard was used to evaluate the curative effect of the affected limb function for the last time.The quality of life of the patients before and after operation was evaluated with the Chinese version of SF-36,and the results at the last follow-up were compared with those before operation.Results All 29 patients were followed up.Imaging bone healing was obtained in 26 of 29 patients at the last follow-up.according to Samantha X-ray score,the score at 6 months after operation was significantly higher than that at 3 months after operation(P < 0.01).At the last follow-up,24 patients with lower extremity surgery recovered well,and 2 patients with upper limb surgery could be painless and severe.Delayed union occurred in 3 cases and recurrence of infection occurred in 1 case 12 weeks after the second stage of operation.The function of the affected limbs was significantly improved compared with that before operation,and the difference was statistically significant(P < 0.01).The results of SF-36 scale showed that at the last follow-up,the scores and total scores of the patients in each dimension were significantly higher than those before operation,the difference was statistically significant(P < 0.01).Conclusion Masquelet technique is an effective method for the treatment of segmental bone defects caused by chronic osteomyelitis.This method is suitable for cases with bone loss and infection.