Asymmetrical bone healing after bone grafting for tibial segmental bone defects - 26/08/26
Abstract |
Introduction |
The study aims to explore whether asymmetrical bone healing occurs after bone grafting for segmental bone defects using the Masquelet technique, and to analyze the underlying causes and potential prevention strategies. The hypothesis was that bone healing after bone grafting for tibial segmental bone defects is asymmetrical.
Methods |
A retrospective analysis was conducted on 67 patients with tibial segmental bone defects treated using the Masquelet technique. After all the bone defects healed, the healing time difference and incidence of local cortical bone loss of the four sides of the bone graft were analyzed, along with the associated causes. The correlation and regression analysis between the patient-specific and surgery-related factors and the difference in anterior versus posterior healing times was performed.
Results |
Mean healing times (months) differed significantly (P < 0.05): posterior (7.2 ± 0.6), lateral (8.4 ± 0.8), medial (9.0 ± 1.0), and anterior (9.6 ± 1.1). The incidence of anterior cortical bone loss (7.46%) was significantly higher than that of posterior and lateral losses (0; P < 0.05). Bivariate correlation and multiple linear regression analyses identified four significant risk factors for differences in healing time (P < 0.05): defect length (β = 0.215), bone graft quantity (β = 0.450), induced membrane (IM) integrity (β = 0.637), and early-stage activity levels (β = 0.597). The regression equation was: Y = −1.954 + 0.637×IM integrity + 0.450×early-stage activity levels + 0.597×bone graft quantity + 0.215×defect length.
Conclusion |
Bone healing after bone grafting for tibial segmental bone defects exhibits asymmetry, with fastest posterior healing, slowest anterior healing and even anterior cortical bone loss. Objective factors (biomechanical environment, graft settling) and subjective factors (defect length, graft stability and quantity, early-stage activity levels) both contribute. These findings inform optimized grafting protocols and rehabilitation strategies to improve clinical outcomes through more balanced healing promotion.
Level of evidence |
IV; retrospective study without a control group.
Le texte complet de cet article est disponible en PDF.Keywords : Segmental bone defect, Bone graft, Bone healing, Asymmetrical healing, Cortical bone loss
Plan
Vol 112 - N° 5
Article 104460- septembre 2026 Retour au numéro
Article précédent
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