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

Table 1 Demographic, clinical and outcome data of subgroup A patients treated with a combined technology Masquelet induced membrane technique + Ilizarov bone transport

Patient	Age (yr), Gender	Mechanism of injury/Туре the fracture	Disease duration (yr)	Type (number) of previous surgeries	Type of nonunion/Infection	Shortening/Bone defect (cm)	Joint Function before surgery	Regenerate/nonunion consolidation completeness	Nonunion consolidation (mo)	Postoperative complication (Paley classification)	Follow-up (mo)	Residual limb length discrepancy (cm)	Further surgery
PTD-1	51, F	MVA, OF	1	EF (1)	TW; Delayed wound healing	3/3	Knee and ankle stiffness	+/+	11	Pin-tract infection Regenerate deformity; Deep vein thrombosis	17	2	-
PTD-2	50, M	MVA, OF	4	Plate (1); EF (1)	HN; History of infection	3/5	Ankle ankyloses	+/+	10	Regenerate deformity	24	5	Rejected further surgery
PTD-3	48, M	IF, OF	3	Plate (1); EF (1)	HN; History of infection	0/3	Ankle stiffness	+/+	7	Pin-tract infection	12	-	-
PTD-4	18, M	IF, OF	3	Plate (2); EF (2)	HN; History of infection	6/3	Ankle ankyloses	+/+	11	Knee joint stiffness	36	6	3-cm lengthening
PTD-5	21, M	IF; OF	1	EF (2)	HN	0/4	Full function	+/+	5	Regenerate deformity	24	-	-
PTD-6	39, M	CT; CF	12	Plate (1); EF (1)	HN; History of infection	1/3	Ankle stiffness	+/+	7	Pin-tract infection	12	-	-
PTD-7	43, M	CT	2	Plate (1)	HN; History of infection	0/4	Ankle stiffness	+/+	8	-	n/a	-	N/A

PTD: Post-traumatic defect; F: Female; M: Male; MVA: Motor vehicle accident; IF: Isolated fracture; CT: Catatrauma; OF: Open fracture; CF: Closed fracture; EF: External fixation; TW: Torsion-wedge nonunion; HN: Hypotrophic nonunion; DP: Defect-pseudarthrosis; N/A: Not available.

Table 2 Demographic, clinical and outcome data of subgroup B patients treated with a combined technology Masquelet induced membrane technique + Ilizarov bone transport

Patient	Age (yr), Gender	Neurofibromatosis	Type (number) of previous surgeries	Paley CPT Type	Shortening/Bone defect (cm)	Joint Function	Regenerate/nonunion consolidation completeness	Consolidation time (mo)	Complications (Paley classification)	Follow-up (mo)	Residual limb length discrepancy (cm)	Recurrence/Further surgery
СPT-1	4, M	I type	-	4C	5/3	Full	+/+	7	Regenerate deformity	24	3	Refracture
СPT -2	3, M	-	EF (1); Nail (1)	4C	5/2	Ankle stiffness	+/+	9	Pin-tract infection	36	3	Refracture
СPT -3	15, F	I type	More than 10 including EF, Nail	4A	15/3	Ankle stiffness	+/+	10	Pin-tract infection	12	12
СPT -4	5, M	I type	-	4B	3/1.5	Full	+/-	7.5	Pin-tract infection	24	3	Ilizarov monofocal compression
СPT -5	8, F	I type	Plate (1); Nail (2); EF (4)	4B	10/3	Ankle ankylosis	+/+	9	-	36	12	Twice Ilizarov lengthening by 6 cm
СPT -6	4, M	I type	EF (1); Autograft (1)	4C	5/1.5	Full	-/-	8	Ischemic regenerate	24	6	Bone defect, rejected further treatment
СPT -7	6, F	-	EF and allograft (2)	4A	5/5	Full	+/+	13.5	Ischemic regenerate	12	5	-
СPT -8	6, F	-	Plate (1); Nail (2); EF (4)	4B	4/3	Full	+/+	7	Pin-tract infection	24	2	Refracture
СPT -9	4, F	-	Plate (1); Nail (2); EF (4)	4A	2/2	Ankle stiffness	+/+	8	-	36	2	Refracture

CPT: Congenital pseudarthrosis of the tibia; F: Female; M: Male; EF: External fixation.

Table 3 Main mean values of preoperative and postoperative data by combined use of Masquelet induced membrane technique + Ilizarov bone transport

Parameter	Subgroup A	Subgroup B
Number of previous surgeries per patient	2.0 ± 0.2	3.3 ± 0.7
LLD at admission (cm)	3.5 ± 0.5	6.0 ± 1.0
Defect size (сm)	3.6 ± 0.3	2.7 ± 0.3
True defect (LLD + bone gap) after debridement relative to the contralateral limb (%)	13.3 ± 1.7	31.0 ± 3.0
Time of spacer retention (d)	42.4 ± 4.5	55.8 ± 6.6
Duration of distraction (d)	43.0 ± 4.2	31.9 ± 4.2
Distraction regenerate size (cm)	3.1 ± 0.2	2.6 ± 0.2
Completeness of defect filling (%)	75.4 ± 10.6	34.6 ± 4.2
External fixation index per cm	143.5 ± 13.2	117.8 ± 8.5
Duration of total external fixation, including spacer retention time (d)	397.0 ± 15.3	270.1 ± 16.3
Mean follow-up time (mo)	20.8 ± 2.7	25.3 ± 2.3

LLD: Limb length discrepancy.