Department of Orthopaedics, 920 Hospital of the Joint Logistics Support Force of the PLA, 212 Daguan Road, Kunming, 650032, China.
J Orthop Surg Res. 2023 Jan 5;18(1):11. doi: 10.1186/s13018-022-03478-7.
Childhood chronic haematogenous osteomyelitis (CCHOM) is a severe condition in paediatric patients. The optimal timing of debridement and the subsequent method of bone reconstruction in CCHOM patients remain controversial. The purpose of this study was to assess the treatment efficacy of Masquelet technique with early debridement and internal fixation in CCHOM of long bones.
Between January 2016 and January 2021, a total of 21 patients (18 males, 3 females) with CCHOM of long bone were included. The mean age was 10.4 years (range, 2-18 years). All cases were treated by a two-stage surgical protocol of Masquelet technique. In the first stage, aggressive debridement, sequestrectomy, and inducing membrane by bone cement spacer were performed after definite diagnosis. In the second stage, cement spacer was removed, and autologous and allogeneic bone was grafted. Internal fixation was used for the first and/or second stage depending on stability requirements. The patients' clinical and imaging results were retrospectively analysed.
The mean follow-up was 31.7 months (range, 21-61 months). None of the patients experienced recurrence of infection. Radiographic bone union time was 4.3 months (range, 2.5-11 months). Five cases underwent re-operation due to complications such as bone resorption or refracture. By the last follow-up visit, bones had healed and all of the patients had resumed daily living and sports activities.
The Masquelet technique with early debridement and internal fixation is a viable surgical method for the management of large long bone defects of CCHOM patients.
儿童慢性血源性骨髓炎（CCHOM）是一种严重的儿科疾病。CCHOM 患者清创和随后骨重建的最佳时机仍存在争议。本研究旨在评估 Masquelet 技术联合早期清创内固定治疗长骨 CCHOM 的疗效。
2016 年 1 月至 2021 年 1 月，共纳入 21 例长骨 CCHOM 患者（18 例男性，3 例女性）。平均年龄为 10.4 岁（范围，2-18 岁）。所有病例均采用 Masquelet 技术两阶段手术方案治疗。在第一阶段，明确诊断后进行积极清创、病灶清除和骨水泥间隔器诱导膜形成。在第二阶段，去除水泥间隔器，并进行自体和同种异体骨移植。根据稳定性要求，在第一阶段和/或第二阶段使用内固定。回顾性分析患者的临床和影像学结果。
平均随访时间为 31.7 个月（范围，21-61 个月）。所有患者均无感染复发。影像学骨愈合时间为 4.3 个月（范围，2.5-11 个月）。5 例患者因骨吸收或再骨折等并发症行再次手术。末次随访时，所有患者均愈合，均恢复日常生活和运动。
Masquelet 技术联合早期清创内固定是治疗 CCHOM 患者大段长骨骨缺损的可行手术方法。
