ReviewEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026
Clinical efficacy comparison of Ilizarov bone transport versus Masquelet technique for cierny-mader type Ⅲ-Ⅳ tibial osteomyelitis with large bone defects.
Review in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo compare the clinical efficacy, safety, and prognostic factors of Ilizarov bone Transport combined with antibiotic-impregnated bone cement filling versus the Masquelet technique in treating Cierny-Mader type Ⅲ-Ⅳ tibial osteomyelitis with large bone defects, providing evidence for clinical decision-making.
methodsA retrospective multicenter study included 112 patients from the Second People's Hospital of Anhui Province (January 2018-January 2023), divided into the Ilizarov group (n = 56) and Masquelet group (n = 56). Propensity score matching (PSM) balanced baseline confounders. Primary outcomes included bone healing time (graft consolidation time for the Masquelet technique), infection control rate, and Paley scoring excellent-good rate; secondary outcomes included treatment course, limb function, complication rates, and reoperation rates.
resultsAll patients were followed up for 12-36 months. After PSM, the Ilizarov group had longer bone healing time (8.2 ± 1.45 vs. 6.5 ± 1.28 months, P < 0.001) but shorter total treatment course (10.5 ± 2.1 vs. 14.8 ± 2.5 months, P < 0.001). The external fixator index (EFI) for the Ilizarov group was 42.3 ± 8.5 days/cm.No significant differences were observed in infection control rate or Paley excellent-good rate (P > 0.05). The Ilizarov group had lower donor site morbidity (0% vs. 17.9%, P = 0.001) but higher pin tract infection rate (12.5% vs. 3.6%, P = 0.026). Bone defect > 12 cm and diabetes mellitus (HbA1c ≥ 7.0%) were independent risk factors for delayed healing (P < 0.05).Reoperation rates were 23.8% (13/56) in the Ilizarov group and 15.0% (8/56) in the Masquelet group (P = 0.28).
conclusionBoth techniques are safe and effective. The Masquelet technique achieves faster bone healing, while the Ilizarov technique avoids donor site trauma and shortens total treatment course. Clinical selection should be individualized based on bone defect length, soft tissue conditions, host comorbidities, vascular status, and patient willingness.
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