| ObjectiveThe management of Infected bone defect is clinically recognized as a hot issue and the challenging problem.Masquelet technique and bone transport technique are the most common options for the reconstruction.Single-arm external stent,as the new tool in the development of bone transport technique,show its advantage gradually while applying.In the present paper,the clinical features of bone infection and the differences of treatment effects between Masquelet technique and bone transport technique with single-arm external stent are summarized from a retrospective analysis of the clinical data of cases,which one of the two techniques is applied during the treatment.The purpose of the study is to share our experience,offering some references for the clinicians.MethodsA total of 66 patients with infectious lower extremity bone defects treated in the Department of Reconstructive and Reconstructive Surgery of Foshan Hospital of Traditional Chinese Medicine from September 2014 to January 2019 were reviewed,including 56 males and 10 females.32 patients were treated with Masquelet technique(group A),and 34 patients were treated with bone transport technique with single-arm external stent(group B).Follow-up X-ray,limb function,and complications of the two groups were compared,so that the clinical treatment effects of the two groups were compared.Results1.There was no significant difference between the two groups in terms of injury site,cause of injury,and Cierny-Mader classification of osteomyelitis(P>0.05).There was a statistically significant difference in age.sex and course of disease between the two groups of patients(P<0.05).2.There were no significant differences in infection indicators(WBC,CRP,ESR),the proportion of detected pathogens,and the number of debridement operations between the two groups of patients(P>0.05).There was a statistically significant difference between the two groups in the proportion of patients with multiple pathogens and soft tissue repair(P<0.05).3.The average length of repaired bone defect in group A was 8.91cm,and the group B was 8.03cm,and the difference was not statistically significant(P>0.05).The bone healing time in group A was longer than that in group B,and there was a statistically significant difference(P<0.05);there was no significant difference in bone healing index between groups A and B(P>0.05).4.The excellent healing rates of bone healing in groups A and B were 75%and 82%,respectively.There was no statistically significant difference in bone healing(P>0.05);the overall excellent rate of limb function in group B was higher than that in group A(81%vs 38%),the difference was statistically significant(P<0.05).5.Complications in group A were bone resorption,iliac area discomfort,poor induced membrane,bone non-union,and recurrence of infection.Group B complications were needle infection,non-healing at the union end,loose fixation nails,drop foot deformity,and infection recurrence,bone nonunion in the mineralized area,deformed force lines;the incidence rates of "problem","disorder",and "real complications" in the A and B groups were 90%,3.3%,6.7%,and 39.4%,40.9%,19.7%,respectively.And the difference was statistically significant(P<0.05).Conclusion1.The infected bone defect with 8cm-9cm on average can be improved satisfactorily by the means of Masquelet technique and bone transport technique with single-arm external stent,which have similar treatment and efficiency;2.Masquelet technique involves a better rehabilitation for limb function while bone transport technique with single-arm external stent causes more complication;3.The age and gender of the patient may be the important factors for clinicians making the choices from these two techniques:they attend to apply Masquelet techniques on older patients and female patients while bone transport technique with single-arm external stent is more likely to be used on patients with multi-resistance bacterial infection. |
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