Clinical Study Of Ilizarov Bone Transport And Masquelet Technique In The Treatment Of Infectious Bone Defects

Objective: Masquelet technique and Ilizarov bone transport are widely used to treat post-traumatic infectious bone defect of lower limb.However,the best surgical therapy remains controversial.It is,important to assess the clinical features,efficacy,disability,and quality of life in patients with post-traumatic infectious bone defect of lower limb treated with masquelet technique vs.Ilizarov bone transport.Methods: A retrospective study performed in 40 patients with post-traumatic infectious bone defect of lower limb in the affiliated hospital of our university from December 1,2015 to December 1,2018.Twenty-two patients were treated with Ilizarov bone transport(20 of tibia and 2 of femur),and 18 patients were treated with Masquelet technique(16 of tibia and 2 of femur).All patients were followed up to the demolition of the fixed device.Paley Rating Scale for bone and function evaluations was the primary outcome measure.Secondary outcomes were healing index,the number of operations and complications.Results: The follow-up period of the two groups was 1-3 years,and the average time was 26.52 months.The efficative rate of both Ilizarov and Masquelet surgeries were above 90%.There was no significant difference in bone healing and functional score between the two groups(P>0.05).However,patients treated with Ilizarov bone transport had longer hospital stay,higher incidence of joint stiffness complications and mild or moderate depression(P<0.05),and patients treated with Masquelet technique had more operations and more flap transplantationes(P<0.05).Patients treated with Ilizarov bone transport without systemic antibiotics had better bone evalution,while patients treated with Masquelet technique and systemic antibiotics had better function evalution(P<0.05).There was no significant difference in healing time,healing index,number of hospitalizations and incidence of anxiety between the two groups(P>0.05).Notably,the patients in Masquelet group had a higher functional score for the treatment of proximal bone defects(P<0.05),but there was no significant difference in the treatment of the backbone defect(P>0.05).Conclusion: Ilizarov and Masquelet techniques both have good effects in the treatment of infectious bone defects.Masquelet technology has a better effect in functional evaluation in the treatment of proximal joint defects,while Ilizarov technology can reduce flap transplantation.