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This is a single-center prospective observational study comparing two techniques for reconstructing bone loss in the lower limbs. The aim of the study was to compare the results of reconstructions using the Masquelet technique with reconstructions using electromagnetic transport nails. The primary endpoint was time to bone healing. This study is the first prospective descriptive study of electromagnetic transport nails.
Segmental bone defects pose a major challenge in orthopaedics due to various causes like trauma, oncology resections, or chronic osteomyelitis. Reconstruction techniques are complex, with Masquelet's method being the most widely used in France, despite mixed outcomes and complications. A novel electromagnetic bone transport technique via intramedullary nailing has emerged as a promising alternative. The primary goal of the study is to compare consolidation times between these two approaches for metaphyseal-diaphyseal bone loss in the lower limbs. Secondary objectives include assessing patient demographics, functional outcomes, quality of life, hospital stays, and adverse events.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Masquelet's method | Other | Patient consulting for a medical reason involving a loss of bone substance in the lower limb in an investigating centre linked to one of these aetiologies for which a reconstruction procedure using a Masquelet technic is envisaged |
|
| Transport nail | Other | Patient consulting for a medical reason involving a loss of bone substance in the lower limb in an investigating centre linked to one of these aetiologies for which a reconstruction procedure using a transport nail is envisaged |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Data collection and self-administered questionnaire. | Other | Exhaustive collection of data in a health data warehouse: collection of clinical, radiological examinations (standard of care), functionals scores and self- administered questionnaire (quality of life). |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of radiological consolidation | Radiological consolidation is defined by an anteroposterior and lateral radiograph showing at least three out of four cortical plates consolidated. This assessment is performed during follow-up by the physician treating the patient and will be confirmed by an evaluation committee at a later stage. | From enrollment to 36 months after |
| Measure | Description | Time Frame |
|---|---|---|
| Functional outcomes : score MSTS | Functional recovery assessed using MSTS (Musculoskeletal Tumor Society Score). It is composed of 6 items , each item on a scale of 0 to 5, with a higher score indicating better function. The total score, ranging from 0 (maximum disability) to 30 (no disability), can be converted to a point scale from 0 to 100. | Baseline, 12 months, 24 months and 36 months |
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Inclusion Criteria:
Patient ≥ 18 years
Minor patient, able to consent to data collection, with the consent of the owner(s)
Patient consulting for a medical reason involving a loss of bone substance in the lower limb in an investigating centre linked to one of these aetiologies for which a reconstruction procedure using a transport nail or Masquelet technique is envisaged:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Benjamin BOUYER, PROF | Contact | +335 56 79 87 18 | b.bouyer@chu-bordeaux.fr | |
| Romain HUGUET | Contact | romain.huguet@chu-bordeaux.fr |
| Name | Affiliation | Role |
|---|---|---|
| Benjamin BOUYER, PROF | University Hospital, Bordeaux | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Bordeaux | Recruiting | Bordeaux | 33000 | France |
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| ID | Term |
|---|---|
| D003625 | Data Collection |
| ID | Term |
|---|---|
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
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| Time to full weight-bearing | Time from initial reconstructive surgery to full weight-bearing without assistive devices, as assessed during routine clinical follow-up. | Baseline, 3 months, 6 months, 12 months, 24 months and 36 months |
| . Functional outcomes : score LEFS | Functional recovery assessed using Lower Extremity Functional Scale (LEFS). It is composed of 20 items , each item on a scale of 0 to 4, with a higher score indicating better function and total score from 0 to 80. | Baseline, 12 months, 24 months and 36 months |
| Functional outcomes : paley Marr score. | Functional recovery assessed using Paley-Maar score. This score is defined from "excellent" to "poor"in fonction of pain, autonomous, .... | Baseline, 12 months, 24 months and 36 months |
| Quality of life | Health-related quality of life evaluated using the SF-36 questionnaire. This questionnaire is composed of 11 items and total score from 0 to 100. | Baseline, 12 months, 24 months and 36 months |
| Adverse events and complications | Occurrence and type of adverse events and complications, including infections, mechanical failures, nonunion, and need for revision surgery. | 3 months, 6 months, 12 months, 24 months and 36 months |
| Bone consolidation rate | Proportion of patients achieving radiological bone consolidation, defined as healing of at least 3 of 4 cortices on standard anteroposterior and lateral radiographs. | From enrollment to 36 months after |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |