Masquelet technique for reconstructing bone defects in open lower limb fracture: Analysis of the relationship between bone defect and bone graft

Objective: The aim of this study was to retrospectively analyze the experience of treating long segmental bone defects. Bone union was used as the criteria for the assessment of the quantitative relationship between tibial bone defects and bone grafts, which could help reduce the complication incidence in patients. Methods: A total of 45 patients with tibial bone defects treated with the Masquelet technique at the Ninth People's Hospital of Wuxi Affiliated to Soochow University between February 2013 and December 2017 were recruited. The age, sex, body mass index (BMI), complications, site of bone defect, length of bone defect, time from the first to the second stage of operation, and postoperative complications (including deep infection, absorption of bone graft, and bone union) were assessed. Results: Forty-two patients, including 17 males (40.5%) and 25 females (59.5%), with segmental bone defect, met the inclusion criteria. The mean age of the patients was 38.5 years (22-55 years). Nineteen patients (45.2%) underwent multiple traumas. The mean length of the bone defect was 6.3 cm. Six patients experienced complications, resulting in the incidence of complications of 14.3%. The relationship between the length of bone defect and volume of bone grafts was Y = 7.210 + 6.954 xX in patients treated with steel plates; Y = 10.962 + 5.029 xX for patients treated with intramedullary nails, and Y = 11.498 + 5.474 xX regardless of methods of internal fixation. Conclusion: Masquelet technique is effective and safe for the treatment of long segmental tibial bone defects. The present study revealed the quantitative relationship between the size of bone defects and bone grafts, thus providing evidence for the selection of treatment strategies for long segmental bone defects in clinical practices, as well as helping to reduce the incidence of complications in Masquelet technique. (C) 2020 The Authors. Published by Elsevier Ltd.

Automated summary

The study retrospectively analyzed the experience of treating long segmental tibial bone defects using the Masquelet technique, showing that it is effective and safe in reducing complication incidence. The quantitative relationship between bone defects and bone grafts was identified, providing evidence for treatment selection and complication reduction.