ANALYSIS OF THE APPLICATION OF THE MASCULÉ TECHNIQUE IN THE TREATMENT OF CRITICAL TIBIAL DEFECTS AFTER GUNSHOT WOUNDS COMPLICATED BY OSTEOMYELITIS

Abstract

Despite significant progress in the development of medicine, post-traumatic osteomyelitis remains one of the biggest problems in the treatment of patients in the orthopedic and traumatology specialty. The Masquelet technique has been most often used in the treatment of chronic osteomyelitis in recent years. Given the high relevance of this problem in foreign and domestic literature, we decided to analyze our own results of treatment of patients after gunshot, shrapnel or mine-explosive wounds of the lower extremities, namely with the presence of critical tibial defects complicated by osteomyelitis under the conditions of using the Masquelet technique. Purpose. To analyze the results of application and determine the clinical and laboratory dependencies of the Masquelet technique in the case of replacement of critical tibial defects after gunshot wounds complicated by osteomyelitis. Methods. The study analyzed 153 patients with critical tibial defects after gunshot wounds complicated by osteomyelitis. Results. With the correct use of the Masquelet technology, bone graft reconstruction was achieved in all patients, the average period was (168.08 ± 62.0) days. Among the shortcomings, it is worth noting the significant dependence of the consolidation period on the condition of the soft tissues, as well as on the pathological pathogen (the presence of Klebsiella pneumoniae or Pseudomonas aureginos in the wound). The terms of consolidation and reconstruction of the bone graft were significantly extended due to these factors. However, the issue of replacing critical bone defects of the tibia after gunshot wounds complicated by osteomyelitis requires further study and comparison of existing techniques.