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Review
. 2023 Dec;15(12):3046-3054.
doi: 10.1111/os.13936. Epub 2023 Nov 14.

Advances in the Application of Bone Transport Techniques in the Treatment of Bone Nonunion and Bone Defects

Zhenhao Li  1 , Jiahe Liu  1 , Chenzhi Li  1 , Mingjian Wu  1 , Yancheng Li  1 , Yan Cui  1 , Wanqi Xiong  1 , Fan Yang  1   2 , Baoyi Liu  1
Affiliations
Review

Advances in the Application of Bone Transport Techniques in the Treatment of Bone Nonunion and Bone Defects

Zhenhao Li et al. Orthop Surg. 2023 Dec.

Abstract

Bone nonunion and bone defects frequently occur following high-energy open injuries or debridement surgeries, presenting complex challenges to treatment and significantly affecting patients' quality of life. At present, there are three primary treatment options available for addressing bone nonunion and bone defects: vascularized bone grafts, the Masquelet technique, and the Ilizarov technique. The Ilizarov technique, also known as distraction osteogenesis, is widely favored by orthopedic surgeons because of several advantages, including minimal soft tissue requirements, low infection risk, and short consolidation time. However, in recent years, the application of the Masquelet technique has resulted in novel treatment methods for managing post-traumatic bone infections when bone defects are present. Although these new techniques do not constitute a panacea, they continue to be the most commonly employed options for treating complex large bone nonunion and bone defects. This review evaluates the currently available research on the Ilizarov and Masquelet bone transport techniques applied at various anatomical sites. Additionally, it explores treatment durations and associated complications to establish a theoretical foundation that can guide clinical treatment decisions and surgical procedures for the management of bone nonunion and bone defects.

Keywords: Bone defects; Bone nonunion; Bone transport; Ilizarov technique; Masquelet technique.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Masquelet technique diagram. (A) Thorough debridement and fixation. (B) Filling with PMMA bone cement. (C) 6–8 weeks after placement of PMMA bone cement, remove the bone cement and membrane induced endograft. (D) Fusion of the grafted bone with the surrounding bone.
FIGURE 2
FIGURE 2
Literature screening flowchart.
FIGURE 3
FIGURE 3
Schematic diagram of Ilizarov technique for tibiofibular fracture. (A) Lower limb tibiofibular fracture with bone discontinuity. (B\C) Ilizarov external fixator stretches and positions the broken end of the bone to a predetermined position by means of wires and braces, stimulating the regenerative potential of the bone tissue by slow and continuous tensile stress. (D) New bone scab formation and tibiofibular fracture healing.
See this image and copyright information in PMC

References

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