Masquelet技术与Ilizarov技术治疗成人下肢长骨感染性骨缺损临床疗效分析

Efficacy Analysis of Masquelet and Ilizarov Technique in the Treatment of Adult Bone Defect of Long Bone of Lower Extremity

目的:比较Masquelet技术与Ilizarov技术治疗成人下肢长骨感染性骨缺损的临床疗效。方法:回顾性分析2014年7月至2017年9月采用Masquelet技术与Ilizarov技术治疗的下肢长骨感染性骨缺损患者38例,其中采用Masquelet技术治疗16例,行Ilizarov技术治疗21例。比较两组患者并发症,骨愈合时间,完全负重时间,术前及末次随访时的膝、踝Iowa评分、SF-36评分。结果:在骨缺损为5~10cm组,Ilizarov技术组骨愈合时间及负重时间上优于Masquelet技术组(P<0.05);在骨缺损为10~15cm,Masquelet技术组骨愈合时间及负重时间优于Ilizarov技术(P<0.05)。两种方法使患者膝、踝Iowa评分、SF-36评分,末次随访都较术前改善。结论:对于成人下肢长骨感染性骨缺损的治疗Masquelet技术与Ilizarov技术治疗都有很好的疗效。骨缺损较多的患者使用Masquelet技术;对于皮肤软组织条件较差,感染严重,自体骨量缺乏,骨缺损范围较少的患者使用Ilizarov技术。

Objective： To compare the clinical effect of Masquelet and Ilizarov technique in the treatment of adult bone defect of long bone with long bone. Methods： A retrospective analysis was made of 38 patients with long bone infection of the lower extremities from July 2014 to September 2017 with Masquelet and Ilizarov techniques,of which 16 were treated with Masquelet,and 21 were treated with Ilizarov. The complications,bone healing time,total weight bearing time,knee and ankle Iowa scores and SF-36 scores before and last follow-up were compared between the two groups. Results： In group 5 ~ 10 cm,the bone healing time and weight bearing time in Ilizarov group were better than those in Masquelet group（ P〈0. 05）. In bone defect group 10 ~ 15 cm,Masquelet group had better bone healing time and weight-bearing time than P Technology（ P〈0.05）. The two methods made the patients＇ knee,ankle Iowa score,SF-36 score,and the last followup better than the preoperative. Conclusion： The treatment of Masquelet and Ilizarov have a good effect on the adult bone defect of long bone. Patients with more bone defects use Masquelet technology,and Ilizarov technology is used for patients with poor skin and soft tissue condition,severe infection,lack of autogenous bone and less bone defect.