Application Of Masquelet Technique And Ilizarov Technique In The Treatment Of Infectious Nonunion

Objective:As a common disease in the direction of bone wound,infectious nonunion has long been concerned by experts and scholars.As it is often accompanied by soft tissue damage,even bone exposure,high energy damage can lead to a lot of bone defects,bone infections,coupled with poor blood supply in some areas,making it a long course,prolonged healing,the patient is very painful.At present,the more mainstream clinical treatment methods are: BMPs,Ilizarov technology,Masquelet technology and Bone gene therapy technology.Among them,Ilizarov technology and Masquelet technology are more advanced and effective technologies.This article reviews retrospectively the Masquelet and Ilizarov techniques for the treatment of infective nonunion,comparing the disadvantages of the two,and summarizing the experience in the treatment of infectious nonunion.The aim of this study was to investigate the therapeutic effects of Masquelet and Ilizarov techniques in the treatment of infectious nonunion.Methods:We retrospectively analyzed the medical records and data of Shanxi Medical University 2rd hospital traumatic orthopedic patients with non-healing bones from January 2015 to January 2018,a total of 30 cases.Among them,19 were male and 11 were female,aged 20~65 years old.Twelve patients were treated with Masquelet technique(MT,group A)and 18 patients were treated with Ilizarov technique(IBT,group B).Statistics of all patients' surgery and hospitalization time,cost during treatment,number of patients undergoing surgery,complications,and efficacy evaluation.Through analyzing the results,compare the advantages and disadvantages of the two technologies.Results:All Ilizarov technique groups were followed up for an average of 18.04±3.67 months.The average healing time was 19.22±3.52 months.The total number of operations was 4.88±1.07 times on average,including 2 to 5 control infections with an average of 1.77±0.94 and bone remodeling of 2 to 5,with an average of 3.11±0.9.The average cost of treatment is 9.5±35.30 million yuan.A total of 13 complications occurred.The clinical efficacy of Paley score criteria: the rate of excellent results of bones was 88.9%.The result of the functional result was 83.33%.The Masquelet technique group followed an average of 17.07±2.69 months;the healing time averaged 6.00±2.17 months.The average number of operations was 4.53±1.20 times,of which the infection was controlled 2 to 6 times with an average 2.33±0.88 times.The bone defect was reconstructed 1 to 3 times with an average of 2.00±0.85 times.The average cost of treatment is 8.00 ± 30,100 yuan.A total of 7 complications occurred.Clinical efficacy Paley score criteria: 91.6% of the results of bone quality.The functional result is excellent and good 75%.Comparing the two groups of operation costs(P<0.05),the difference was statistically significant;the total number of operations(P>0.05)was not statistically significant,and there was a statistically significant difference in the number of controlled infection operations and the number of bone reconstruction operations(P<0.05).Conclusion:Under the existing medical technology conditions,the use of Ilizarov technology and Masquelet technology for the treatment of infectious nonunion can achieve satisfactory results.It is undeniable that both advantages and disadvantages exist.The first,Ilizarov technology to repair long bone defects is not limited by the amount of bone supply,the infection control rate is high;Second,Masquelet technology is simple and safe,the second phase according to the patient's condition can choose internal fixation device,increase Patient Comfort;Third,Ilizarov technology has more operations than Masquelet technology,and the cost of treatment is slightly higher,which has a greater impact on the daily life of patients;Fourth,Ilizarov technology has a higher incidence of complications than Masquelet technology,but within a controllable range.Fifth,the Ilizarov technique requires almost no bone grafting,while the Masquelet technique requires a large amount of bone grafting,and autologous bone supply is limited to the application of the treatment of large segmental bone defects.Sixth,Ilizarov technology requires relatively low soft tissue,and Masquelet technology Need better soft tissue conditions,if necessary,need to advance skin flap transplantation to repair the wound.