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Prospective randomized comparison of bone transport versus Masquelet technique in infected gap nonunion of tibia

  • Trauma Surgery
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The present prospective randomized study compared the bone transport technique (BT) and Masquelet technique (MT) in the treatment of infected gap non-union of the tibia.

Patients and methods

Total 25 patients with infected gap non-union of the tibia with bone gap upto 6 cm were randomised into BT group (group I, 13 patients) and MT (group II, 12 patients). The mean age was 31.77 years in group I and 39.67 years in group II. The mean intra-operative bone gap was 3.92 cm in group I and 3.79 cm in group II. Monolateral fixator was applied in nine patients each in both groups, while four and three fractures were stabilized with ring fixators in group I and II, respectively. Mean follow-up was 31.62 months and 30.42 months in group I and II, respectively. Bone and functional results were compared using the association for the study and application of the method of Ilizarov (ASAMI) criteria.


The average fixator period was 9.42 and 16.33 months in group I and II, respectively (p < 0.001). Union was achieved in 12 (92%) patients and 6 (50%) patients in group I and II, respectively. The functional results were excellent (eight and two), good (four and six), fair (zero and three) and poor (one and one) in group I and II respectively, (p 0.23). The Bone results were excellent, good and poor in nine, three and one patients in group I, and three, three and six patients in group II respectively, (p 0.109).


The functional and bone results were comparable but more reliable in bone transport than the Masquelet technique. The fixator duration and incidence of non-union were higher in MT group. Ilizarov bone transport technique should be preferred in infected non-union of the tibia with bone loss upto 6 cm.

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Authors and Affiliations



RR chief operating surgeon for most of the surgeries, wrote the manuscript, statistical analysis, conducted the data analysis. PKS assisted most of the surgeries, conducted the data analysis, wrote the manuscript, statistical analysis. JD assisted most of the surgeries, conducted the patient follow-up and record-keeping, edited the manuscript. JW data collection, data analysis, wrote the manuscript. RS conducted the data analysis, edited the manuscript. DB conducted the data analysis, edited the manuscript.

Corresponding author

Correspondence to Pankaj Kumar Sharma.

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The authors declared that they have no conflict of interest.

Informed consent

Informed and written consent was taken from all the patients for surgical interventions as well as for the study participations. This study was approved by the Institutional Review Board (IRB ID: IEC/Th/18/Ortho/03).

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Rohilla, R., Sharma, P.K., Wadhwani, J. et al. Prospective randomized comparison of bone transport versus Masquelet technique in infected gap nonunion of tibia. Arch Orthop Trauma Surg 142, 1923–1932 (2022).

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