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改良Masquelet技术与克氏针外固定辅助自体骨移植治疗节段性掌指骨骨缺损的临床效果比较

Comparison of Clinical Effects of the Modified Masquelet Technique and Kirschner Wire External Fixation-Assisted Autogenous Bone Transplantation in the Treatment of Segmental Metacarpophalangeal Bone Defects.

作者信息

Liu Zeng-Bing, Li Qiang, Liu Wen-Xia, Li Xin-Hai, Ma Kai, Huo Yu-Bao, Wang Jin-Guang, Wang Qing-He, Yu Ya-Dong

机构信息

Department of Hand and Foot Surgeries, The No. 4 People's Hospital of Hengshui, Hengshui, 053000, People's Republic of China.

Department of Hand Surgeries, The Third Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China.

出版信息

Int J Gen Med. 2022 Feb 16;15:1619-1635. doi: 10.2147/IJGM.S343617. eCollection 2022.

DOI:10.2147/IJGM.S343617
PMID:35210833
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8858955/
Abstract

OBJECTIVE

The present study aims to explore the (1) clinical effects of the modified Masquelet technique, whose improved Masquelet technique innovates the in vitro plasticity of the bone cement module and prefabricated hollow design, and the Kirschner wire external fixation-assisted autologous bone transplantation technique in the treatment of segmental metacarpophalangeal bone defects and (2) the differences between the two techniques.

METHODS

The clinical data of 32 patients with segmental metacarpophalangeal bone defects (15 patients treated with the modified Masquelet technique and 17 patients treated with the self-made Kirschner wire external fixation technique) admitted to our department between January 2012 and January 2020 were retrospectively analyzed. The postoperative bone healing time, hand function, and complications were compared between the two groups.

RESULTS

The two groups were comparable; there were no significant differences in age, sex, length of bone defect, and time from injury to operation between the two groups (P > 0.05). All patients were followed up with for 6-24 months (average = 13.7 months), and all patients with segmental metacarpophalangeal bone defects achieved fracture healing. The postoperative hospital stay, fracture healing time, functionary scores of the affected limb, and incidence of severe complications were better in the modified group than in the external fixation group (P < 0.05).

CONCLUSION

Compared with the Kirschner wire external fixation stent assisted autologous bone transplantation, the improved Masquelet technique has the advantages of simple operation, fast healing, accurate effect, wide indications, and less complications, making it more worthy of clinical promotion.

摘要

目的

本研究旨在探讨（1）改良的Masquelet技术（其改进的Masquelet技术创新了骨水泥模块的体外可塑性和预制空心设计）联合克氏针外固定辅助自体骨移植技术治疗节段性掌指骨骨缺损的临床效果，以及（2）两种技术之间的差异。

方法

回顾性分析2012年1月至2020年1月期间我科收治的32例节段性掌指骨骨缺损患者的临床资料（15例采用改良的Masquelet技术治疗，17例采用自制克氏针外固定技术治疗）。比较两组术后骨愈合时间、手部功能及并发症情况。

结果

两组具有可比性；两组在年龄、性别、骨缺损长度、受伤至手术时间方面差异无统计学意义（P＞0.05）。所有患者均随访6 - 24个月（平均13.7个月），所有节段性掌指骨骨缺损患者均实现骨折愈合。改良组术后住院时间、骨折愈合时间、患肢功能评分及严重并发症发生率均优于外固定组（P＜0.05）。

结论

与克氏针外固定支架辅助自体骨移植相比，改良的Masquelet技术具有操作简单、愈合快、效果确切、适应证广、并发症少等优点，更值得临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46f5/8858955/fb73ed2499ee/IJGM-15-1619-g0011.jpg
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