Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec;143(12):7081-7096.
doi: 10.1007/s00402-023-05049-9. Epub 2023 Sep 11.

Surgical treatment of critical size bone defects with Masquelet technique versus bone transport: a systematic review and meta-analysis of comparative studies

Lucrezia Allesina #  1 , Mattia Alessio-Mazzola #  2 , Alberto Belluati  3 , Salvatore Mosca  1 , Giacomo Placella #  1 , Vincenzo Salini #  1
Affiliations
Review

Surgical treatment of critical size bone defects with Masquelet technique versus bone transport: a systematic review and meta-analysis of comparative studies

Lucrezia Allesina et al. Arch Orthop Trauma Surg. 2023 Dec.

Abstract

Introduction: To date, the management of critical-sized bone defects lacks a universally accepted approach among orthopedic surgeons. Currently, the main options to treat severe bone loss include autologous grafting, free vascularized bone transfer, bone transport and induced-membrane technique. The purpose of this study is to critically compare the outcomes of Masquelet technique and bone transport to provide a higher level of evidence regarding the indexed techniques.

Material and methods: The authors conducted a systematic search on several databases according to the PRISMA guidelines. English-written reports comparing outcomes of the Masquelet technique versus the bone transport technique in patients with critical-sized defects in lower extremities were included.

Results: Six observational studies involving 364 patients were included. The systematic review and meta-analysis of pooled data showed no significant difference in most outcomes, except for ASAMI bone outcomes and residual deformity, which showed better results in the bone transport group. The 64% of patients treated with Masquelet technique obtained excellent/good bone ASAMI results compared to 82.8% with bone transport (p = 0.01). Post-operative residual deformity was 1.9% with the bone transport method versus 9.7% with the Masquelet technique (p = 0.02).

Conclusions: Both the Masquelet technique and bone transport showed comparable results for the management of critical-sized bone defects of the lower limb. However, these findings must be carefully interpreted due to the high risk of bias. Further prospective randomized controlled trials are necessary to better clarify the strengths and limitations of these two techniques and to identify the variables affecting the outcomes.

Keywords: Bone transport; Critical-size bone defects; Distraction osteogenesis; Induced-membrane technique; Masquelet technique.

PubMed Disclaimer

References

    1. Keating JF, Simpson AHRW, Robinson CM (2005) The management of fractures with bone loss. J Bone Jt Surg Br 87(2):142–150. https://doi.org/10.1302/0301-620x.87b2.15874 - DOI
    1. Nauth A, Schemitsch E, Norris B et al (2018) Critical-size bone defects: is there a consensus for diagnosis and treatment?: is there a consensus for diagnosis and treatment? J Orthop Trauma 32(3):S7–S11. https://doi.org/10.1097/bot.0000000000001115 - DOI
    1. Obremskey W, Molina C, Collinge C et al (2014) Current practice in the management of open fractures among orthopaedic trauma surgeons. Part B: management of segmental long bone defects. A survey of Orthopaedic Trauma Association members. J Orthop Trauma 28(8):e203–e207. https://doi.org/10.1097/BOT.0000000000000034 - DOI - PubMed
    1. Masquelet A, Kanakaris NK, Obert L et al (2019) Bone repair using the Masquelet technique. J Bone Jt Surg Am 101(11):1024–1036. https://doi.org/10.2106/JBJS.18.00842 - DOI
    1. Lasanianos NG, Kanakaris NK, Giannoudis PV (2010) Current management of long bone large segmental defects. Orthop Trauma 24(2):149–163. https://doi.org/10.1016/j.mporth.2009.10.003 - DOI

LinkOut - more resources