Department of Orthopedic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.
Int Orthop. 2022 Sep;46(9):1937-1944. doi: 10.1007/s00264-022-05494-y. Epub 2022 Jun 30.
Masquelet and Ilizarov techniques have their advantages and shortcomings in the reconstruction of bone defects. The aim of this study was to evaluate the effectiveness of the combination of both techniques for the management of infected tibial nonunion to combine the advantages of both techniques with avoidance of shortcomings of both of them.
A prospective single-centre study was performed during the period from 2012 to 2019. Patients with the infected nonunion of the tibia with bone defect were included. Patients with pathological fractures or non-infected bone loss were excluded. Management protocol for all patients consisted of two stages. The first stage was Masquelet induced membrane technique and the second stage was Ilizarov bone transport. The results were assessed based on both objective (clinical and radiographic evaluation) and subjective criteria (limb function and patient satisfaction).
Thirty-two patients were included in this study. The mean size of the defect was 6 cm. Ilizarov bone transport was done through the induced membrane chamber in all cases with an average follow-up of 28 months. Successful reconstruction without recurrence of infection was achieved in 30 cases (94%). No other bone or soft tissue procedure was needed with satisfactory functional outcome in 27 out of 30 cases (90%). Three cases had unsatisfactory results due to leg length discrepancy, joint stiffness, and persistent pain.
Masquelet-Ilizarov technique can be used for the management of infected nonunion tibia with high satisfactory results without the need for complex soft tissue procedures.
Masquelet 和 Ilizarov 技术在骨缺损重建中各有优缺点。本研究旨在评估两种技术联合应用于感染性胫骨骨不连的疗效，以结合两种技术的优点，避免两者的缺点。
这是一项 2012 年至 2019 年期间进行的前瞻性单中心研究。纳入患有感染性胫骨骨不连伴骨缺损的患者。排除病理性骨折或无感染性骨丢失的患者。所有患者的治疗方案均分为两个阶段。第一阶段是 Masquelet 诱导膜技术，第二阶段是 Ilizarov 骨搬运。结果基于客观（临床和影像学评估）和主观标准（肢体功能和患者满意度）进行评估。
本研究共纳入 32 例患者。缺损平均大小为 6cm。在所有病例中，均通过诱导膜室进行 Ilizarov 骨搬运，平均随访 28 个月。30 例（94%）成功重建，无感染复发。27 例（90%）患者功能结局满意，无需其他骨或软组织手术。3 例因肢体长度差异、关节僵硬和持续疼痛而结果不满意。
Masquelet-Ilizarov 技术可用于治疗感染性胫骨骨不连，疗效满意，无需复杂的软组织手术。
