Ilizarov bone transport combined with the Masquelet technique for bone defects of various etiologies (preliminary results)  

作　　者：Dmitry Y Borzunov Sergey N Kolchin Denis S Mokhovikov Tatiana A Malkova 

机构地区：[1]Department of Taumatology and Orthopedics,Ural State Medical University,Ekaterinburg 620109,Russia [2]Orthopaedic Department 4,Ilizarov National Medical Research Center for Traumatology and Orthopaedics,Kurgan 640014,Russia [3]Department of Medical Information and Analysis,Ilizarov National Medical Research Center for Traumatology and Orthopaedics,Kurgan 640014,Russia

出　　处：《World Journal of Orthopedics》2022年第3期278-288,共11页世界骨科杂志（英文版）

摘　　要：BACKGROUND The Ilizarov bone transport(IBT)and the Masquelet induced membrane technique(IMT)have specific merits and shortcomings,but numerous studies have shown their efficacy in the management of extensive long-bone defects of various etiologies,including congenital deficiencies.Combining their strong benefits seems a promising strategy to enhance bone regeneration and reduce the risk of refractures in the management of post-traumatic and congenital defects and nonunion that failed to respond to other treatments.AIM To combine IBT and IMT for the management of severe tibial defects and pseudarthrosis,and present preliminary results of this technological solution.METHODS Seven adults with post-traumatic tibial defects(subgroup A)and nine children(subgroup B)with congenital pseudarthrosis of the tibia(CPT)were treated with the combination of IMT and IBT after the failure of previous treatments.The mean number of previous surgeries was 2.0±0.2 in subgroup A and 3.3±0.7 in subgroup B.Step 1 included Ilizarov frame placement and spacer introduction into the defect to generate the induced membrane which remained in the interfragmental gap after spacer removal.Step 2 was an osteotomy and bone transport of the fragment through the tunnel in the induced membrane,its compression and docking for consolidation without grafting.The outcomes were retrospectively studied after a mean follow-up of 20.8±2.7 mo in subgroup A and 25.3±2.3 mo in subgroup B.RESULTS The“true defect”after resection was 13.3±1.7%in subgroup A and 31.0±3.0%in subgroup B relative to the contralateral limb.Upon completion of treatment,defects were filled by 75.4±10.6%and 34.6±4.2%,respectively.Total duration of external fixation was 397±9.2 and 270.1±16.3 d,including spacer retention time of 42.4±4.5 and 55.8±6.6 d,in subgroups A and B,respectively.Bone infection was not observed.Postoperative complications were several cases of pin-tract infection and regenerate deformity in both subgroups.Ischemic regeneration was observed in two cases

关 键 词：Ilizarov bone transport Induced membrane technique Post-traumatic tibial defect Congenital pseudarthrosis of the tibia Distraction osteogenesis Regeneration 

分 类 号：R687.3[医药卫生—骨科学]