Jian-wen Zhao, Cheng-Juan Long, Xiaowei Wang, Wu Zhuo, Song Zhanlin, Jianzheng Zhang, Zhi Liu
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First stage included debridement, polymethyl methacrylate (PMMA) filling and regional flap coverage. The soft tissue defect of the 5 cases included 10 cm×8 cm in 2 cases, 8 cm×7 cm, 8 cm×5 cm, and 5 cm×3 cm each in one case. Bone defect included 4 cm×3 cm×2 cm in two cases, 3 cm×3 cm× 2 cm in two cases and 3 cm×1 cm×1 cm in one case. Second stage was 3D printing titanium cage combined with masquelet technology of rib autograft. Time of bone union, morphology of calcaneus, position of implant, Maryland score and AOFAS hind foot score were recorded to evaluate the clinical outcome. \n \n \nResults \nAll five patients were followed up for an average time of 18.2 months (range, 12-30 months). Infection happened in one patient 2 months after first stage operation and successfully treated by debridement and PMMA replacement. Incision of the rest 4 cases all healed successfully. Germiculture of the five cases included Methicillin-resistant Staphylococcus aureus (MRSA) in three cases, Staphylococcus epidermidis in one case and Bacterium coli in one case. All five patients got calcaneus bone union after second stage operation. The average time for bone union was 4.32 (range, 3-8) month. Bone trabecular were observed in CT scan 13 (range, 10-22) month post-operation. Average Maryland score in 12 months post-operation was 92 (range, 86-98) and average AOFAS ankle hind foot score was 89.8 (range, 83-100). \n \n \nConclusion \n3D printing titanium cage and Masquelet technology maybe an effective treatment for calcaneus infective defect. \n \n \nKey words: \nCalcaneus; Infection; Wounds and injuries","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"40 1","pages":"310-316"},"PeriodicalIF":0.0000,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reconstruction of calcaneus infective defect with 3D printing titanium cage and Masquelet technology\",\"authors\":\"Jian-wen Zhao, Cheng-Juan Long, Xiaowei Wang, Wu Zhuo, Song Zhanlin, Jianzheng Zhang, Zhi Liu\",\"doi\":\"10.3760/CMA.J.ISSN.0253-2352.2020.05.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo evaluate the clinical outcome of 3D printing titanium cage combined with Masquelet technology for the treatment of calcaneus infective defect. \\n \\n \\nMethods \\nData of 5 cases with chronic calcaneus infectivedefect treated with regional flap, 3D printing titanium cage combined with Masquelet technology with rib autograft from January 2017 to January 2019 were retrospectively analyzed. There were 3 males and 2 females, with an average age of 37 years old (range, 17-52 years). The mechanism of the five patients included two motor vehicle incidents, two high fall injuries and one rolling compaction. All patients were treated by two-stage procedures. First stage included debridement, polymethyl methacrylate (PMMA) filling and regional flap coverage. The soft tissue defect of the 5 cases included 10 cm×8 cm in 2 cases, 8 cm×7 cm, 8 cm×5 cm, and 5 cm×3 cm each in one case. Bone defect included 4 cm×3 cm×2 cm in two cases, 3 cm×3 cm× 2 cm in two cases and 3 cm×1 cm×1 cm in one case. Second stage was 3D printing titanium cage combined with masquelet technology of rib autograft. Time of bone union, morphology of calcaneus, position of implant, Maryland score and AOFAS hind foot score were recorded to evaluate the clinical outcome. \\n \\n \\nResults \\nAll five patients were followed up for an average time of 18.2 months (range, 12-30 months). Infection happened in one patient 2 months after first stage operation and successfully treated by debridement and PMMA replacement. Incision of the rest 4 cases all healed successfully. Germiculture of the five cases included Methicillin-resistant Staphylococcus aureus (MRSA) in three cases, Staphylococcus epidermidis in one case and Bacterium coli in one case. All five patients got calcaneus bone union after second stage operation. The average time for bone union was 4.32 (range, 3-8) month. Bone trabecular were observed in CT scan 13 (range, 10-22) month post-operation. Average Maryland score in 12 months post-operation was 92 (range, 86-98) and average AOFAS ankle hind foot score was 89.8 (range, 83-100). \\n \\n \\nConclusion \\n3D printing titanium cage and Masquelet technology maybe an effective treatment for calcaneus infective defect. \\n \\n \\nKey words: \\nCalcaneus; Infection; Wounds and injuries\",\"PeriodicalId\":36405,\"journal\":{\"name\":\"中华骨科杂志\",\"volume\":\"40 1\",\"pages\":\"310-316\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华骨科杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2020.05.008\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华骨科杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2020.05.008","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的评价三维打印钛支架结合Masquelet技术治疗跟骨感染性缺损的临床疗效。方法回顾性分析2017年1月至2019年1月应用区域皮瓣、3D打印钛笼结合Masquelet技术自体肋骨移植治疗慢性跟骨感染性缺损5例的临床资料。男3例，女2例，平均年龄37岁（17-52岁）。五名患者的发病机制包括两起机动车事故、两起高处坠落受伤和一起碾压。所有患者均接受两阶段治疗。第一阶段包括清创术、聚甲基丙烯酸甲酯（PMMA）填充和区域皮瓣覆盖。5例软组织缺损：10cm×8cm 2例，8cm×7cm、8cm×5cm、5cm×3cm各1例。骨缺损4 cm×3 cm×2 cm 2例，3 cm×3厘米×2 cm两例，3厘米×1厘米×1 cm 1例。第二个阶段是3D打印钛支架结合自体肋骨移植的masquelet技术。记录骨愈合时间、跟骨形态、植入位置、Maryland评分和AOFAS后脚评分，评价临床疗效。结果5例患者平均随访18.2个月（12～30个月）。一例患者在第一期手术后2个月发生感染，并通过清创和PMMA置换成功治疗。其余4例切口均成功愈合。5例病例的细菌培养包括3例耐甲氧西林金黄色葡萄球菌（MRSA）、1例表皮葡萄球菌和1例大肠杆菌。5例患者均经二期手术后跟骨愈合。骨愈合的平均时间为4.32（范围3-8）个月。术后13个月（10～22个月）CT扫描可见骨小梁。术后12个月的平均Maryland评分为92（范围86-98），AOFAS踝后足评分为89.8（范围83-100）。结论三维打印钛网结合Masquelet技术是治疗跟骨感染性缺损的有效方法。关键词：跟骨；感染；伤口和伤害
Reconstruction of calcaneus infective defect with 3D printing titanium cage and Masquelet technology
Objective
To evaluate the clinical outcome of 3D printing titanium cage combined with Masquelet technology for the treatment of calcaneus infective defect.
Methods
Data of 5 cases with chronic calcaneus infectivedefect treated with regional flap, 3D printing titanium cage combined with Masquelet technology with rib autograft from January 2017 to January 2019 were retrospectively analyzed. There were 3 males and 2 females, with an average age of 37 years old (range, 17-52 years). The mechanism of the five patients included two motor vehicle incidents, two high fall injuries and one rolling compaction. All patients were treated by two-stage procedures. First stage included debridement, polymethyl methacrylate (PMMA) filling and regional flap coverage. The soft tissue defect of the 5 cases included 10 cm×8 cm in 2 cases, 8 cm×7 cm, 8 cm×5 cm, and 5 cm×3 cm each in one case. Bone defect included 4 cm×3 cm×2 cm in two cases, 3 cm×3 cm× 2 cm in two cases and 3 cm×1 cm×1 cm in one case. Second stage was 3D printing titanium cage combined with masquelet technology of rib autograft. Time of bone union, morphology of calcaneus, position of implant, Maryland score and AOFAS hind foot score were recorded to evaluate the clinical outcome.
Results
All five patients were followed up for an average time of 18.2 months (range, 12-30 months). Infection happened in one patient 2 months after first stage operation and successfully treated by debridement and PMMA replacement. Incision of the rest 4 cases all healed successfully. Germiculture of the five cases included Methicillin-resistant Staphylococcus aureus (MRSA) in three cases, Staphylococcus epidermidis in one case and Bacterium coli in one case. All five patients got calcaneus bone union after second stage operation. The average time for bone union was 4.32 (range, 3-8) month. Bone trabecular were observed in CT scan 13 (range, 10-22) month post-operation. Average Maryland score in 12 months post-operation was 92 (range, 86-98) and average AOFAS ankle hind foot score was 89.8 (range, 83-100).
Conclusion
3D printing titanium cage and Masquelet technology maybe an effective treatment for calcaneus infective defect.
Key words:
Calcaneus; Infection; Wounds and injuries
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