Department of Orthopaedics Surgery, Wuxi No.9 People's Hospital Affiliated to Soochow University, No. 999 Liangxi Road, Wuxi, 214000, Wuxi, China.
Department of Orthopaedics Surgery, Wuxi No.9 People's Hospital Affiliated to Soochow University, No. 999 Liangxi Road, Wuxi, 214000, Wuxi, China.
Injury. 2021 Apr;52(4):988-995. doi: 10.1016/j.injury.2020.12.009. Epub 2020 Dec 29.
The aim of this study was to retrospectively analyze the experience of treating long segmental bone defects. Bone union was used as the criteria for the assessment of the quantitative relationship between tibial bone defects and bone grafts, which could help reduce the complication incidence in patients.
A total of 45 patients with tibial bone defects treated with the Masquelet technique at the Ninth People's Hospital of Wuxi Affiliated to Soochow University between February 2013 and December 2017 were recruited. The age, sex, body mass index (BMI), complications, site of bone defect, length of bone defect, time from the first to the second stage of operation, and postoperative complications (including deep infection, absorption of bone graft, and bone union) were assessed.
Forty-two patients, including 17 males (40.5%) and 25 females (59.5%), with segmental bone defect, met the inclusion criteria. The mean age of the patients was 38.5 years (22-55 years). Nineteen patients (45.2%) underwent multiple traumas. The mean length of the bone defect was 6.3 cm. Six patients experienced complications, resulting in the incidence of complications of 14.3%. The relationship between the length of bone defect and volume of bone grafts was Y = 7.210 + 6.954 × X in patients treated with steel plates; Y = 10.962 + 5.029 × X for patients treated with intramedullary nails, and Y = 11.498 + 5.474 × X regardless of methods of internal fixation.
Masquelet technique is effective and safe for the treatment of long segmental tibial bone defects. The present study revealed the quantitative relationship between the size of bone defects and bone grafts, thus providing evidence for the selection of treatment strategies for long segmental bone defects in clinical practices, as well as helping to reduce the incidence of complications in Masquelet technique.
本研究旨在回顾性分析长节段骨缺损的治疗经验。骨愈合被用作评估胫骨骨缺损与植骨定量关系的标准，这有助于降低患者并发症的发生率。
回顾性分析 2013 年 2 月至 2017 年 12 月苏州大学附属无锡第九人民医院采用 Masquelet 技术治疗的 45 例胫骨骨缺损患者的临床资料，分析患者的年龄、性别、体质量指数（BMI）、并发症、骨缺损部位、骨缺损长度、一期与二期手术间隔时间及术后并发症（包括深部感染、植骨吸收、骨愈合）等情况。
42 例患者符合纳入标准，其中男 17 例（40.5%），女 25 例（59.5%），均为节段性骨缺损；年龄 22~55 岁，平均 38.5 岁；19 例（45.2%）患者合并多发伤；骨缺损长度 6.3cm；6 例患者出现并发症，并发症发生率为 14.3%。钢板内固定患者骨缺损长度与植骨量的关系为 Y=7.210+6.954×X，髓内钉内固定患者为 Y=10.962+5.029×X，无论内固定方式如何，均为 Y=11.498+5.474×X。
Masquelet 技术治疗长节段胫骨骨缺损安全有效，本研究揭示了骨缺损大小与植骨量的定量关系，为临床长节段骨缺损治疗策略的选择提供了依据，有助于降低 Masquelet 技术并发症的发生率。
