{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:30:58Z","timestamp":1792625458089,"version":"4.5.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007950","name":"Tanta University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007950","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract\u00a0<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Masquelet and Ilizarov techniques have their advantages and shortcomings in the reconstruction of bone defects. The aim of this study was to evaluate the effectiveness of the combination of both techniques for the management of infected tibial nonunion to combine the advantages of both techniques with avoidance of shortcomings of both of them.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients and methods<\/jats:title>\n                <jats:p>A prospective single-centre study was performed during the period from 2012 to 2019. Patients with the infected nonunion of the tibia with bone defect were included. Patients with pathological fractures or non-infected bone loss were excluded. Management protocol for all patients consisted of two stages. The first stage was Masquelet induced membrane technique and the second stage was Ilizarov bone transport. The results were assessed based on both objective (clinical and radiographic evaluation) and subjective criteria (limb function and patient satisfaction).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Thirty-two patients were included in this study. The mean size of the defect was 6\u00a0cm. Ilizarov bone transport was done through the induced membrane chamber in all cases with an average follow-up of 28\u00a0months. Successful reconstruction without recurrence of infection was achieved in 30 cases (94%). No other bone or soft tissue procedure was needed with satisfactory functional outcome in 27 out of 30 cases (90%). Three cases had unsatisfactory results due to leg length discrepancy, joint stiffness, and persistent pain.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Masquelet\u2013Ilizarov technique can be used for the management of infected nonunion tibia with high satisfactory results without the need for complex soft tissue procedures.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00264-022-05494-y","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T23:13:33Z","timestamp":1656630813000},"page":"1937-1944","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Masquelet\u2013Ilizarov technique for the management of bone loss post debridement of infected tibial nonunion"],"prefix":"10.1007","volume":"46","author":[{"given":"Abdullah","family":"Khaled","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"El-Gebaly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"El-Rosasy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"5494_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00590-014-1576-z","volume":"25","author":"ME Hake","year":"2015","unstructured":"Hake ME, Oh JK, Kim JW, Ziran B, Smith W, Hak D, Mauffrey C (2015) Difficulties and challenges to diagnose and treat post-traumatic long bone osteomyelitis. Eur J Orthop Surg Traumatol 25:1\u20133. https:\/\/doi.org\/10.1007\/s00590-014-1576-z","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"5494_CR2","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/s0736-0266(03)00165-7","volume":"22","author":"P Pelissier","year":"2004","unstructured":"Pelissier P, Masquelet AC, Bareille R, Pelissier SM, Amedee J (2004) Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res 22:73\u201379. https:\/\/doi.org\/10.1016\/s0736-0266(03)00165-7","journal-title":"J Orthop Res"},{"key":"5494_CR3","doi-asserted-by":"publisher","first-page":"835","DOI":"10.2106\/00004623-199506000-00004","volume":"77","author":"GK Dendrinos","year":"1995","unstructured":"Dendrinos GK, Kontos S, Lyritsis E (1995) Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg Am 77:835\u2013846. https:\/\/doi.org\/10.2106\/00004623-199506000-00004","journal-title":"J Bone Joint Surg Am"},{"key":"5494_CR4","first-page":"426","volume":"80","author":"P Yin","year":"2014","unstructured":"Yin P, Zhang Q, Mao Z, Li T, Zhang L, Tang P (2014) The treatment of infected tibial nonunion by bone transport using the Ilizarov external fixator and a systematic review of infected tibial nonunion treated by Ilizarov methods. Acta Orthop Belg 80:426\u2013435","journal-title":"Acta Orthop Belg"},{"key":"5494_CR5","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1080\/17453670510045534","volume":"76","author":"PB Sch\u00f6ttle","year":"2005","unstructured":"Sch\u00f6ttle PB, Werner CM, Dumont CE (2005) Two-stage reconstruction with free vascularized soft tissue transfer and conventional bone graft for infected nonunions of the tibia: 6 patients followed for 1.5 to 5 years. Acta Orthop 76:878\u2013883. https:\/\/doi.org\/10.1080\/17453670510045534","journal-title":"Acta Orthop"},{"key":"5494_CR6","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1016\/j.injury.2020.03.041","volume":"51","author":"MA El-Rosasy","year":"2020","unstructured":"El-Rosasy MA, Ayoub MA (2020) Traumatic composite bone and soft tissue loss of the leg: region-specific classification and treatment algorithm. Injury 51:1352\u20131361. https:\/\/doi.org\/10.1016\/j.injury.2020.03.041","journal-title":"Injury"},{"key":"5494_CR7","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s11751-015-0221-7","volume":"10","author":"LC Marais","year":"2015","unstructured":"Marais LC, Ferreira N (2015) Bone transport through an induced membrane in the management of tibial bone defects resulting from chronic osteomyelitis. Strategies Trauma Limb Reconstr 10:27\u201333. https:\/\/doi.org\/10.1007\/s11751-015-0221-7","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"5494_CR8","doi-asserted-by":"publisher","unstructured":"Masquelet AC, Begue T (2010) The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am 41:27\u201337; table of contents. https:\/\/doi.org\/10.1016\/j.ocl.2009.07.011","DOI":"10.1016\/j.ocl.2009.07.011"},{"issue":"Suppl 6","key":"5494_CR9","doi-asserted-by":"publisher","first-page":"S53","DOI":"10.1016\/s0020-1383(16)30840-3","volume":"47","author":"PV Giannoudis","year":"2016","unstructured":"Giannoudis PV, Harwood PJ, Tosounidis T, Kanakaris NK (2016) Restoration of long bone defects treated with the induced membrane technique: protocol and outcomes. Injury 47(Suppl 6):S53-s61. https:\/\/doi.org\/10.1016\/s0020-1383(16)30840-3","journal-title":"Injury"},{"key":"5494_CR10","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1016\/j.injury.2017.03.042","volume":"48","author":"K Tong","year":"2017","unstructured":"Tong K, Zhong Z, Peng Y, Lin C, Cao S, Yang Y, Wang G (2017) Masquelet technique versus Ilizarov bone transport for reconstruction of lower extremity bone defects following posttraumatic osteomyelitis. Injury 48:1616\u20131622. https:\/\/doi.org\/10.1016\/j.injury.2017.03.042","journal-title":"Injury"},{"key":"5494_CR11","doi-asserted-by":"publisher","unstructured":"Morris R, Hossain M, Evans A, Pallister I (2017) Induced membrane technique for treating tibial defects gives mixed results. Bone Joint J 99-b:680\u2013685. https:\/\/doi.org\/10.1302\/0301-620x.99b5.Bjj-2016-0694.R2","DOI":"10.1302\/0301-620x.99b5.Bjj-2016-0694.R2"},{"key":"5494_CR12","doi-asserted-by":"crossref","unstructured":"El-Rosasy M, Mahmoud A, El-Gebaly O, Rodriguez-Collazo E, Thione A (2019) Definition of bone transport from an orthoplastic perspective. International Journal of Orthoplastic Surgery 2:62+","DOI":"10.29337\/ijops.33"},{"key":"5494_CR13","doi-asserted-by":"crossref","unstructured":"El-Rosasy M, Mahmoud A, El-Gebaly O, Lashin A, Rodriguez-Collazo E (2019) Debridement technique and dead space management for infected non-union of the tibia. International Journal of Orthoplastic Surgery 2:29+","DOI":"10.29337\/ijops.34"},{"key":"5494_CR14","doi-asserted-by":"publisher","unstructured":"Jain AK, Sinha S (2005) Infected nonunion of the long bones. Clin Orthop Relat Res:57\u201365. https:\/\/doi.org\/10.1097\/01.blo.0000152868.29134.92","DOI":"10.1097\/01.blo.0000152868.29134.92"},{"key":"5494_CR15","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1302\/0301-620x.89b1.17595","volume":"89","author":"MA El-Rosasy","year":"2007","unstructured":"El-Rosasy MA (2007) Acute shortening and re-lengthening in the management of bone and soft-tissue loss in complicated fractures of the tibia. J Bone Joint Surg Br 89:80\u201388. https:\/\/doi.org\/10.1302\/0301-620x.89b1.17595","journal-title":"J Bone Joint Surg Br"},{"key":"5494_CR16","doi-asserted-by":"crossref","unstructured":"Paley D, Catagni MA, Argnani F, et al (1989) Ilizarov treatment of tibial nonunions with bone loss. Clin Orthop Relat Res 146\u2013165","DOI":"10.1097\/00003086-198904000-00017"},{"key":"5494_CR17","first-page":"346","volume":"45","author":"AC Masquelet","year":"2000","unstructured":"Masquelet AC, Fitoussi F, Begue T, Muller GP (2000) Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet 45:346\u2013353","journal-title":"Ann Chir Plast Esthet"},{"key":"5494_CR18","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s11751-010-0085-9","volume":"5","author":"C Iacobellis","year":"2010","unstructured":"Iacobellis C, Berizzi A, Aldegheri R (2010) Bone transport using the Ilizarov method: a review of complications in 100 consecutive cases. Strategies Trauma Limb Reconstr 5:17\u201322. https:\/\/doi.org\/10.1007\/s11751-010-0085-9","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"5494_CR19","first-page":"10058","volume":"8","author":"J Peng","year":"2015","unstructured":"Peng J, Min L, Xiang Z et al (2015) Ilizarov bone transport combined with antibiotic cement spacer for infected tibial nonunion. Int J Clin Exp Med 8:10058\u201310065","journal-title":"Int J Clin Exp Med"},{"key":"5494_CR20","doi-asserted-by":"publisher","first-page":"230949901771624","DOI":"10.1177\/2309499017716242","volume":"25","author":"AH van Niekerk","year":"2017","unstructured":"van Niekerk AH, Birkholtz FF, de Lange P et al (2017) Circular external fixation and cemented PMMA spacers for the treatment of complex tibial fractures and infected nonunions with segmental bone loss. J Orthop Surg (Hong Kong) 25:2309499017716242. https:\/\/doi.org\/10.1177\/2309499017716242","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"5494_CR21","doi-asserted-by":"publisher","first-page":"278","DOI":"10.5312\/wjo.v13.i3.278","volume":"13","author":"DY Borzunov","year":"2022","unstructured":"Borzunov DY, Kolchin SN, Mokhovikov DS, Malkova TA (2022) Ilizarov bone transport combined with the Masquelet technique for bone defects of various etiologies (preliminary results). World J Orthop 13:278\u2013288. https:\/\/doi.org\/10.5312\/wjo.v13.i3.278","journal-title":"World J Orthop"}],"container-title":["International Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-022-05494-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00264-022-05494-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-022-05494-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T10:10:20Z","timestamp":1660212620000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00264-022-05494-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["5494"],"URL":"https:\/\/doi.org\/10.1007\/s00264-022-05494-y","relation":{},"ISSN":["0341-2695","1432-5195"],"issn-type":[{"value":"0341-2695","type":"print"},{"value":"1432-5195","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,30]]},"assertion":[{"value":"6 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the local institutional review board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was obtained from all the participants included in our study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}