Clinical efficacy of Masquelet technique combined with artificial dermis in the treatment of Gustilo type IIIB injuries with large-area bone exposure: A retrospective study

To compare the clinical efficacy of Masquelet technique combined with artificial dermis versus conventional vacuum sealing drainage (VSD) technique in the treatment of Gustilo type IIIB injuries with large-area bone exposure. Clinical data of 63 patients with Gustilo type IIIB injuries and large-area bone exposure admitted from January 2023 to February 2025 were retrospectively analyzed. Based on the actual treatment received, patients were retrospectively divided into the observation group (Masquelet technique combined with artificial dermis, n=32) and the control group (conventional VSD technique, n=31). This was a non-randomized retrospective study. To reduce selection bias, propensity score matching (PSM) was used to balance baseline characteristics between the two groups. Bone union rate, bone healing time, pain scores, range of motion (ROM) recovery rate, limb function scores, quality of life scores, and complication rates were compared between the two groups. After PSM, 32 patients in the observation group and 31 in the control group were included in the final analysis, with no statistically significant differences in baseline characteristics between groups (P>0.05). For bone healing indicators, the complete union rate in the observation group was 87.5% (28/32), significantly higher than 64.5% (20/31) in the control group (χ²=4.513, P=0.034, RR=1.36, 95%CI: 1.03-1.79). Bone healing time in the observation group was (14.2±3.6) weeks, significantly shorter than (18.7±4.8) weeks in the control group (t=4.068, P