Use of double plate fixation with Masquelet technique fixation for large segmental bone defects of distal tibia: A Retrospective Study and Literature Review

Background: There is no effective consensus on the choice of internal fixation method for the Masquelet technique in the treatment of large segmental bone defects of the distal tibia. The aim of the study was to investigate the outcomes of the Masquelet technique combined with double plate fixation in the treatment of large segmental bone defects of the distal tibia. Methods This was a retrospective study. 21 patients with large segmental bone defects of the distal tibia were treated between June 2017 and June 2020. The length of bone defect ranged from 6.0 cm to 10.5 cm (mean, 7.8 cm). In the first stage of treatment, following complete debridement, a cement spacer was placed to induce membrane formation. In the second stage, double plate fixation and autologous cancellous bone graft were used for bone reconstruction. Each patient’s full weight-bearing time, bone healing time, and Iowa ankle score were recorded, and the occurrence of any complications was noted. Results All patients were followed up for 16 to 26 months (mean, 20.2 months). The group mean full weight-bearing time and bone healing time after bone grafting were 3.8 (± 0.7) months and 7.5 (± 0.8) months, respectively. During the treatment, one patient had a wound infection on the medial side of the leg, and the medial plate was removed. The wound healed after debridement, and the infection did not recur. After extraction of iliac bone for grafting, one patient had a large number of iliac bone defects, which were filled using cement spacer. Patients reported mild pain in the left bone extraction area after surgery. The Iowa ankle score was 84–94, versus preoperative and postoperative scores, P < 0.05, with 15 cases rated as “excellent” on this system, and 6 cases rated as “good.” Conclusions The Masquelet technique combined with double plate fixation is a safe and effective method for the repair of large segmental bone defects of the distal tibia.