Treatment Of Bone Defect In Chronic Osteomyelitis With Membrane Induction And Bone Transport

Objective: To explore the clinical effect of membrane induction and bone transport in the treatment of chronic osteomyelitis.Methods: 28 cases of chronic osteomyelitis from August 2013 to January 2019 were analyzed retrospectively.According to the different operation methods,16 patients(group A)were divided into membrane induction group(12 males and 4 females),the age was 22-55 years old,the follow-up time was 14-32 months,and the length of bone defect was 4-9 cm.12 patients(group B),9 males and 3 females,aged 27-49 years old,were followed up for 18-39 months.After thorough debridement,the cost,time of bone healing,time of weight-bearing,incidence of postoperative complications,functional scores of knee joint and ankle joint of all patients were compared.Results: There was no significant difference in general data between the membrane induction group and the bone transport group(P > 0.05).The treatment time,total hospitalization cost,X-ray frequency and total loading time were better in the membrane-induced group than in the bone transport group,and the difference was statistically significant(P < 0.05).The total incidence of complications in the membrane-induced group was lower than that in the bone transport group,and the difference was statistically significant(P < 0.05).In this study,the last knee HSS score,ankle AOFAS score and Maryland foot score of the membrane-induced technique group were better than that of the bone transport technique group,with statistically significant differences(P < 0.05).HSS score of knee joint,AOFAS score of ankle joint and Maryland foot score in the last and middle postoperative period of the two groups were better than those before surgery,and the difference was statistically significant(P < 0.05).There was no significant difference in preoperative knee HSS score,ankle AOFAS score and Maryland foot score between the two groups(P > 0.05).Conclusion:Our current research shows that the membrane induction technology is superior to the bone transport group in the satisfaction of limb function score and result in the treatment of chronic osteomyelitis bone defect.Membrane induction technology has fewer complications,fewer X-ray examinations,shorter healing time and higher function score.However,the treatment process of bone transport is long,the fixation time and healing time are long,the nail track infection,loosening,joint adhesion and stiffness,nerve injury and many other complications.