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Masquelet 技术治疗下肢创伤后急性骨缺损的长期疗效。

Long term results of lower limb posttraumatic acute bone defects treated with masquelet technique.

机构信息

Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

Trauma Department, Hospital Universitario 12 de Octubre, Madrid, Spain.

出版信息

Injury. 2021 Jul;52 Suppl 4:S99-S103. doi: 10.1016/j.injury.2021.02.057. Epub 2021 Mar 2.

Abstract

INTRODUCTION

Several alternatives are now available when treating posttraumatic acute bone defects. Masquelet's technique represents a safe procedure to treat lower limb open fractures associated with significant bone defects and allows surgeons to try to reduce complications incidence.

MATERIAL AND METHODS

Retrospective study based on patients´ record files and images (2015-2017). Twelve patients suffering acute bone defect, treated using Masquelet technique, were evaluated. A total of ten patients were finally included after exclusion criteria were applied.

RESULTS

Average time from injury to first stage surgery was 11 days. Free flaps were required in three cases (two latissimus dorsi and one anterolateral thigh flap). Time to second stage surgery was 115 days on average. As bone graft, reaming irrigation-aspiration system was associated to this technique. Consolidation was achieved in all patients but one after an average time of 8.4 months. There was only one case of limb shortening of 20 mm. There was no case of nonunion or infection, and patients could perform daily basic activities independently. VAS mean score was one point one year after final surgery.

CONCLUSIONS

Masquelet's technique achieves encouraging results when treating lower limb acute bone defects. Using this technique, surgeons could decrease infection incidence in open fractures with severe bone loss. On the other hand, it is a two-stage surgery process, which makes the process longer.

摘要

简介

治疗创伤后急性骨缺损有多种选择。Masquelet 技术是治疗伴有严重骨缺损的下肢开放性骨折的一种安全方法,可减少并发症的发生。

材料与方法

回顾性研究,基于患者的病历档案和影像资料(2015-2017 年)。共评估了 12 例采用 Masquelet 技术治疗急性骨缺损的患者,排除标准后最终纳入 10 例患者。

结果

从受伤到第一阶段手术的平均时间为 11 天。有 3 例患者(2 例背阔肌皮瓣和 1 例股前外侧皮瓣)需要游离皮瓣。第二阶段手术的平均时间为 115 天。再植骨时,使用扩髓冲洗抽吸系统联合该技术。所有患者平均 8.4 个月后均达到骨愈合,但有 1 例患者发生 20mm 的肢体短缩。无骨不连或感染病例,患者可独立进行日常基本活动。末次手术后 1 年,VAS 平均评分为 1 分。

结论

Masquelet 技术治疗下肢急性骨缺损可获得令人鼓舞的结果。使用该技术,可降低严重骨丢失的开放性骨折的感染发生率。但另一方面,它是一个两阶段的手术过程,这使得治疗过程更长。

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