The Effect Of Masquelet Technique Combined With Artificial Bone Grafting In The Treatment Of Segmental Bone Defects

Objective: The purpose of this study was to explore the clinical efficacy of the Masquelet technique combined with artitificial bone grafting in the reconstruction of segmental bone defects in limbs,and to report the early results of our methoeds of using this special technique.Methods: From January 2012 to December 2019,the clinical and imaging data of patients with segmental bone defects who received Masquelet technique for treatment were systematically collected.Among 29 patients,There were 21 males and 8 females,with an average age of 48.5 years(16-76 years).All patients were followed up by clinical and radiographic studies,complications were recorded and time to bone union paley score for bone healing was evaluated.For single factor,correlation analysis was used and for multiple comparison independent-samples t test was used to determine the factors associated with time of bone healing.Results: Among the included 29 patients,there were 11 open fractures,13 postoperative infections after internal fixation,1 giant-cell tumor of bone,2 bone tuberculosis and 2 others(hematopoietic osteomyelitis,gout).The bone defect sites were 1 in radial,3 in humerus,4 in femur,14 in tibia,3 in calcaneus,and 4 others(phalanx and phalanx).There were significant diffirences in the length of bone defect and the time of bone healing between upper limbs and lower limbs(P<0.05).All patients received two-stage surgical treatment with an average interval of 111 days except one.The mean bone defect was 7.5cm(0.66cm-31.8cm).There was no significant correlation between bone defect length and bone healing time(r=0.24,P>0.05).The mean debridement frequency of infectious bone defect was 2.3 times(1-7 times)before the PMMA was finally implanted.Soft tissue coverage was warranted in 5 cases.The infection recurred in 1 case,5 cases of superficial infection and 4 of them were flap related.2 cases of plate fracture were noteced among 29 cases.Clinical and radiographic healing was achieved in 27 cases with an average bone healing time of 6.9 months.The bone healing rate was 93.1%.Conclusion: Compared with traditional treatment of segmental bone defects,the Masquelet technique has several advantages like higher bone healing rate,faster osseointegration,lower recurrence rate of infection,fewer complications,and the bone healing time is not affected by the length of bone defect,which is worthy of clinical promotion.