Early Clinical Efficacy Of Masquelet Technique For The Reconstruction Of Chronic Osteomyelitis Defects

Objective:To investigate the early clinical efficacy of masquelet technique for reconstruction of large bone defects after debridement in paitents with chronic osteomyelitis.Methods:A total of4patients suffering from chronic osteomyelitisadmitted in our department during and had large bone defects after debridement and resection of the sequestra during December2010to December2014were recruited and retrospectively analyzed in this study. There are3male cases,1female case; Age37-72, an average of56.5years. Bone defect length is5.4cm-11.2cm, average7.1cm. All the patients were treated by using Masquelet or modified Masquelet technique of two phases’surgery. Phase1carry out a thorough debridement, fix limb with external fixation or external fixation plates, mixed with10%vancomycin or imipenem of polymethyl methacrylate (PMMA) bone cement will be filled in after remodeling bone defect, and finally close the wound without tension. Phase2, after the cutting and separatting from the soft tissue layer by layer, carefully cut induced membrane, remove the inside bone cement out, and then fill induced membrane cavity with bone graft, close layer by layer. Record the limb function and postoperative complications, bone healing time.The follow up evaluation included clinical complications; time of bone healing, and limbs function. Results:All4cases were followed for3to16months. The incisions of all4cases were healed, no recurrence of infection of incision, no signs of recurrence of osteomyelitis, no donor site complications, no postoperative recurrence fractures occurred etc needing unplanned operation. External fixators were applied in2cases, and plate used as external fixation in2cases. Bone has healed in1case of which the X ray shown a little lateral displacement deformity, but the function is good.l case’s bone healing has obtained in X-ray, and wound healing is good without pain, now the patient can walk on crutches with part weight. In the rest2cases, callus growth was seen on X-ray. At the time of the last follow-up, the patients" wound healing is good and can walk on crutches part weightwithout pain.Conclusion:Masquelet technique can effectively treat the long bone defects after debridement of chronic osteomyelitis and has the characteristics of easy operation, less complications.