Clinical Study Of Masquelet Technology Combined With Locking Plate For The Treatment Of Infectious Bone Defects In Lower Limbs

ObjectiveTo explore the clinical effects of using Masquelet technology in the treatment of infectious bone defects in the lower limbs with two different surgical methods,external and internal locking plates,and analyze the relevant factors that affect bone healing time in the treatment.MethodsA retrospective analysis of 47 patients with lower extremity infectious bone defects treated with Masquelet technology and locking plates treated by the Department of Orthopaedics of the First Affiliated Hospital of Zhengzhou University from January 2016 to January 2019,including 34 males and 13 females,using locking plates There were 22 cases of external fixation(external group),16 cases of males and 6 cases of females;25 cases of internal fixation(built-in group)using locking plates,17 cases of males,and 8 cases of females.The success rates of the first-stage surgery in the two groups were compared.The number of operations,bone healing time,bone healing grade,and lower limb function score 1 year after surgery were used to evaluate its efficacy.At the same time,correlation analysis was performed on some factors that may affect the patient's bone healing time.ResultsAll patients eventually healed and were followed up.The average follow-up time was 14 months(12-17 months).The success rate of stage 1 surgery in the two groups was 82%in the external group,80%in the built-in group,and P=0.874.The difference was not statistically significant;the number of operations was 2.5 ± 1.1 times in the external group,2.4 ± 1.1 times in the built-in group,and P=0.951,and the difference was not statistically significant;the bone healing time was 8.5±1.7 months in the external group,and the built-in group It was 8.7 ± 1.7 months,P=0.654,the difference was not statistically significant;the excellent rate was 91%in the external group of bone healing grade,the excellent rate was 88%in the internal group,and P=0.663,the difference was not statistically significant;1 year after surgery the lower limb function score was 81.1 ± 5.1 in the external group and 82.7±5.3 in the built-in group,and P=0.304,the difference was not statistically significant.The bone healing time was analyzed for all patients.The lesion was 7.8±1.8 months for femoral patients,9.1 ± 1.4 months for tibia patients,P=0.023,and the difference was statistically significant;7.9 ± 1.7 months for patients<45 years old For patients?45 years old,9.9±1.2 months,P<0.001,the difference was statistically significant;for patients with bone defect length<5cm,it was 8.5 ± 1.7 months,for patients with bone defect length?5cm,it was 8.5±1.8 months,P=0.997,The difference was not statistically significant;9.1 ± 1.6 months in patients with bone defects<40cm3,8.3 ±1.6 months in patients with bone defects?40cm3,P=0.123,the difference was not statistically significant;patients with infection time<9 months were 8.5±1.9 months,infection time ?9 months was 8.6 ± 1.5 months,P=0.838,the difference was not statistically significant;bone graft type was 8.6 ± 1.9 months for patients with autologous bone,and mixed bone patients was 8.2 ± 1.7 months,P=0.420,the difference was not statistically significant.Conclusions1.Masquelet technology combined with locking plate for the treatment of infectious bone defects in the lower limbs has the characteristics of simple and rapid,high cure rate,and good functional recovery.External or built-in locking plate has good curative effects.2.The bone healing time of Masquelet technology combined with locking plate for the treatment of infectious bone defects of the lower limbs has nothing to do with the length of the bone defect,the amount of the bone defect,the infection time,and the type of bone graft.It is related to the location and age of the injury.Patients with tibial injury take longer to heal than those with femoral injury,and older patients take longer to heal than younger patients.