Membrane Induced Osteogenesis (Masquelet Technique) versus Bone Transport in Management of Large Bone Defects of the Lower Limb

Abstract

Background: Management of bone defects is controversial , between grafting, acute shortening , and up to amputation and disarticulation in extensive defects . This study is a comparative study between 2 modalities for management of bone defects to reveal advantages and disadvantages of each modality. Aim of the work : The aim of this work is to assess and compare results of membrane induced osteogenesis and bone transport in extensive bone defects of the lower limb . Patients and methods: We prospectively studied 40 patients (29 males and 11 females) with lower limb bony defects. They were divided into two groups according to the method of reconstruction using either Masquelet technique in 20 patients (group A) or bone transport in the other 20 patients (group B). The mean age of the patients was 35.2 years in group A and was 35.2 years in group B. diagnosis was infected non union (20 cases: 10 in group A &10 in group B) and posttraumatic and non infective defects (20 cases:10 in group A & 10 in group B) . The most common anatomical site was the tibia (24 cases:9 in group A &15 in group B).. Patients were reviewed every 3 monthly for a minimum period of 1 year. Regular outpatient follow-up was done with a mean period of 18.35±5.58 months in group A and 18.25±3.95 months in group B. Results: In cases of group A ( Masquelet group) 12 cases showed complete union , and the other 8 cases showed no evidence of union ( all from infected group ). While in case of group B (bone transport group) all cases showed complete union Conclusion: bone transport technique is more reliable method with more expectable results for healing and infection eradication.Up to our study , Masquelet technique can be used in the following indications:. small ,metaphyseal and posttraumatic or non infective defects