Rohilla Rajesh, Sharma Pankaj Kumar, Wadhwani Jitendra, Das Jyotirmoy, Singh Roop, Beniwal Deepsikha
Department of Sports Medicine, PGIMS, Pt. B. D. Sharma, Health University, Rohtak, 124001, Haryana, India.
Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur Romana, Mandi Dabwali Road, Bathinda, 151001, Punjab, India.
Arch Orthop Trauma Surg. 2022 Aug;142(8):1923-1932. doi: 10.1007/s00402-021-03935-8. Epub 2021 May 13.
The present prospective randomized study compared the bone transport technique (BT) and Masquelet technique (MT) in the treatment of infected gap non-union of the tibia.
Total 25 patients with infected gap non-union of the tibia with bone gap upto 6 cm were randomised into BT group (group I, 13 patients) and MT (group II, 12 patients). The mean age was 31.77 years in group I and 39.67 years in group II. The mean intra-operative bone gap was 3.92 cm in group I and 3.79 cm in group II. Monolateral fixator was applied in nine patients each in both groups, while four and three fractures were stabilized with ring fixators in group I and II, respectively. Mean follow-up was 31.62 months and 30.42 months in group I and II, respectively. Bone and functional results were compared using the association for the study and application of the method of Ilizarov (ASAMI) criteria.
The average fixator period was 9.42 and 16.33 months in group I and II, respectively (p < 0.001). Union was achieved in 12 (92%) patients and 6 (50%) patients in group I and II, respectively. The functional results were excellent (eight and two), good (four and six), fair (zero and three) and poor (one and one) in group I and II respectively, (p 0.23). The Bone results were excellent, good and poor in nine, three and one patients in group I, and three, three and six patients in group II respectively, (p 0.109).
The functional and bone results were comparable but more reliable in bone transport than the Masquelet technique. The fixator duration and incidence of non-union were higher in MT group. Ilizarov bone transport technique should be preferred in infected non-union of the tibia with bone loss upto 6 cm.
本前瞻性随机研究比较了骨搬运技术（BT）和Masquelet技术（MT）治疗胫骨感染性骨缺损不愈合的效果。
25例胫骨感染性骨缺损不愈合且骨缺损达6厘米的患者被随机分为骨搬运技术组（I组，13例患者）和Masquelet技术组（II组，12例患者）。I组平均年龄为31.77岁，II组为39.67岁。I组术中平均骨缺损为3.92厘米，II组为3.79厘米。两组各有9例患者应用单侧固定器，I组另外4例和II组另外3例骨折采用环形固定器固定。I组和II组的平均随访时间分别为31.62个月和30.42个月。采用伊里扎洛夫方法研究与应用协会（ASAMI）标准比较骨和功能结果。
I组和II组的平均固定器使用时间分别为9.42个月和16.33个月（p<0.001）。I组和II组分别有12例（92%）和6例（50%）患者实现骨愈合。I组和II组的功能结果分别为优（8例和2例）、良（4例和6例）、可（0例和3例）和差（1例和1例），（p=0.23）。I组骨结果为优、良和差的患者分别为9例、3例和1例，II组分别为3例、3例和6例，（p=0.109）。
功能和骨结果相当，但骨搬运技术比Masquelet技术更可靠。Masquelet技术组的固定器使用时间和不愈合发生率更高。对于骨缺损达6厘米的胫骨感染性不愈合，应首选伊里扎洛夫骨搬运技术。
