Masquelet膜诱导技术治疗股骨干骨折术后无菌性骨不连的临床观察

Clinical observation of Masquelet induced membrane technique in treatment of aseptic nonunion after femoral shaft fracture surgery

目的探讨Masquelet膜诱导技术治疗股骨干骨折术后无菌性骨不连的临床疗效。方法回顾性分析2016年2月至2018年3月北部战区总医院收治并确诊的15例无菌性骨不连患者的临床资料,所有研究对象均采用Masquelet膜诱导技术分期治疗。记录患者术前及末次随访特种外科医院膝关节评分(HSS)、Merle D′Aubigne髋关节功能评分、视觉模拟量表(VAS)评分及术后并发症情况。结果本研究中15例患者术后均随访10~24个月,平均(13±1.5)个月。末次随访HSS、Merle D′Aubigne和VAS评分分别为(85.3±2.4)分、(17.2±0.4)分和(1.9±0.7)分,较术前(57.9±5.6)分、(6.7±1.1)分和(5.1±0.8)分改善明显,差异均具有统计学意义(P<0.05)。结论Masquelet膜诱导技术可作为治疗股骨干骨折术后无菌性骨不连的有效手段,能够促进骨不连的愈合,恢复肢体功能,降低隐匿性感染患者术后感染复发的风险,提高手术成功率。

Objective To investigate the clinical effect of Masquelet induced membrane technique in the treatment of aseptic nonunion after femoral shaft fracture surgery.Methods A retrospective case-series study was conducted to analyze the clinical data of 15 patients with aseptic nonunion after femoral shaft fracture surgery admitted to General Hospital of North Theater Command from February 2016 to March 2018.All patients were treated in stages with Masquelet induced membrane technique.Preoperative and last follow-up visual analogue scale(VAS)scores,Merle D′Aubignehip function scores,hospital for special surgery(HSS)knee scores,and postoperative complications were recorded.Results All 15 patients were followed up for 10 to 24 months,with an average of(13±1.5)months.The HSS score,Merle D′Aubigne function score and VAS score at the last follow-up were(85.3±2.4),(17.2±0.4)and(1.9±0.7)respectively,which were all improved significantly compared with(57.9±5.6),(6.7±1.1)and(5.1±0.8)before surgery,and the differences were statistically significant(P<0.05).Conclusion Masquelet induced membrane technique can be used as an effective method for the treatment of aseptic nonunion after femoral shaft fractures surgery,which may promote the healing of bone nonunion,restore the limb function,reduce the risk of infection recurrence after occult infection and improve the success rate of surgery.